Provider Demographics
NPI:1659151488
Name:NORTHSHORE MOBILITY & WELLNESS CONCIERGE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:NORTHSHORE MOBILITY & WELLNESS CONCIERGE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHARYN
Authorized Official - Middle Name:CROZIER
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:703-402-6412
Mailing Address - Street 1:19 SWAN ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3119
Mailing Address - Country:US
Mailing Address - Phone:703-402-6412
Mailing Address - Fax:
Practice Address - Street 1:19 SWAN ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3119
Practice Address - Country:US
Practice Address - Phone:703-402-6412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty