Provider Demographics
NPI:1649745175
Name:LOWELL REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:LOWELL REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:PYATIGORSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-721-6281
Mailing Address - Street 1:77 E. MERRIMACK STREET
Mailing Address - Street 2:UNIT 4
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852
Mailing Address - Country:US
Mailing Address - Phone:978-677-7636
Mailing Address - Fax:978-856-7667
Practice Address - Street 1:77 E. MERRIMACK STREET
Practice Address - Street 2:UNIT 4
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852
Practice Address - Country:US
Practice Address - Phone:978-677-7636
Practice Address - Fax:978-856-7667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy