Provider Demographics
NPI:1558025221
Name:HEALTHPRO PEDIATRICS, LLC
Entity Type:Organization
Organization Name:HEALTHPRO PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP OUTPATIENT PEDIATRICS
Authorized Official - Prefix:
Authorized Official - First Name:TERRA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-437-4364
Mailing Address - Street 1:76 ACCORD PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 NATALIE WAY
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-3557
Practice Address - Country:US
Practice Address - Phone:508-858-5991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty