Provider Demographics
NPI:1912204850
Name:BURLINGTON PHYSICAL THERAPY, PC DBA ORTHOPAEDICS PLUS
Entity Type:Organization
Organization Name:BURLINGTON PHYSICAL THERAPY, PC DBA ORTHOPAEDICS PLUS
Other - Org Name:ORTHOPAEDICS PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEZICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:781-229-8011
Mailing Address - Street 1:100 CUMMINGS CTR
Mailing Address - Street 2:SUITE 121Q
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6115
Mailing Address - Country:US
Mailing Address - Phone:978-927-0907
Mailing Address - Fax:978-927-0537
Practice Address - Street 1:100 CUMMINGS CTR
Practice Address - Street 2:SUITE 121Q
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-927-0907
Practice Address - Fax:978-927-0537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty