Provider Demographics
NPI:1619200979
Name:JK THERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:JK THERAPY ASSOCIATES, LLC
Other - Org Name:FURNACE BROOK PHYSICAL THERAPY-EASTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:BERNASCONI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:617-770-4167
Mailing Address - Street 1:21 TOTMAN ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-7564
Mailing Address - Country:US
Mailing Address - Phone:617-770-4167
Mailing Address - Fax:617-770-0971
Practice Address - Street 1:519 FOUNDRY ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-2743
Practice Address - Country:US
Practice Address - Phone:617-770-4167
Practice Address - Fax:617-770-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy