Provider Demographics
NPI:1528542883
Name:MIDDLESEX PHYSICAL THERAPY II LLC
Entity Type:Organization
Organization Name:MIDDLESEX PHYSICAL THERAPY II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:UM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-452-6795
Mailing Address - Street 1:138 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1014
Mailing Address - Country:US
Mailing Address - Phone:978-452-6795
Mailing Address - Fax:978-746-8471
Practice Address - Street 1:138 BROADWAY
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1014
Practice Address - Country:US
Practice Address - Phone:978-452-6795
Practice Address - Fax:978-746-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty