Provider Demographics
NPI:1821398207
Name:CENTOLA, JAMES (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:CENTOLA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MALLOY ST
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1412
Mailing Address - Country:US
Mailing Address - Phone:508-533-3756
Mailing Address - Fax:
Practice Address - Street 1:42 LANDAU ROAD
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-5030
Practice Address - Country:US
Practice Address - Phone:617-658-1048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6488225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist