Provider Demographics
NPI:1689716276
Name:MAULION, SANCHO (SANCHO MAULION, MSPT)
Entity Type:Individual
Prefix:
First Name:SANCHO
Middle Name:
Last Name:MAULION
Suffix:
Gender:M
Credentials:SANCHO MAULION, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BABCOCK ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5960
Mailing Address - Country:US
Mailing Address - Phone:617-595-0557
Mailing Address - Fax:
Practice Address - Street 1:77 WARREN ST BLDG 4
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3601
Practice Address - Country:US
Practice Address - Phone:617-254-1140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17558225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist