Provider Demographics
NPI:1013135441
Name:KENNEDY BROTHERS PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:KENNEDY BROTHERS PHYSICAL THERAPY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-372-6317
Mailing Address - Street 1:790 CHIEF JUSTICE CUSHING HWY
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-2140
Mailing Address - Country:US
Mailing Address - Phone:781-383-8001
Mailing Address - Fax:781-383-8009
Practice Address - Street 1:790 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-2140
Practice Address - Country:US
Practice Address - Phone:781-383-8001
Practice Address - Fax:781-383-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty