Provider Demographics
NPI:1700864139
Name:ORTHO & SPORTS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ORTHO & SPORTS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-273-4125
Mailing Address - Street 1:PO BOX 120008
Mailing Address - Street 2:260 TREMONT ST
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02112
Mailing Address - Country:US
Mailing Address - Phone:617-636-5175
Mailing Address - Fax:617-636-5176
Practice Address - Street 1:260 TREMONT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02112
Practice Address - Country:US
Practice Address - Phone:617-636-5175
Practice Address - Fax:617-636-5176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy