Provider Demographics
NPI:1659578466
Name:ABLEBODIES
Entity Type:Organization
Organization Name:ABLEBODIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:617-594-1987
Mailing Address - Street 1:413 NEPONSET AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3131
Mailing Address - Country:US
Mailing Address - Phone:617-265-4555
Mailing Address - Fax:617-265-4644
Practice Address - Street 1:413 NEPONSET AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-3131
Practice Address - Country:US
Practice Address - Phone:617-265-4555
Practice Address - Fax:617-265-4644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty