Provider Demographics
NPI:1972620169
Name:PHYSICAL THERAPY & REHABILITATION ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY & REHABILITATION ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-459-0370
Mailing Address - Street 1:16 PINE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-3100
Mailing Address - Country:US
Mailing Address - Phone:978-459-0370
Mailing Address - Fax:978-459-2358
Practice Address - Street 1:16 PINE ST STE 5
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-3100
Practice Address - Country:US
Practice Address - Phone:978-459-0370
Practice Address - Fax:978-459-2358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy