Provider Demographics
NPI:1134551252
Name:BOSTON THERAPY INC
Entity type:Organization
Organization Name:BOSTON THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL & MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:PT MT
Authorized Official - Phone:617-561-7246
Mailing Address - Street 1:50 MERIDIAN ST
Mailing Address - Street 2:STE 2
Mailing Address - City:E BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128
Mailing Address - Country:US
Mailing Address - Phone:617-561-7246
Mailing Address - Fax:617-561-7247
Practice Address - Street 1:827 N MAIN ST
Practice Address - Street 2:STE 6
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5751
Practice Address - Country:US
Practice Address - Phone:401-453-5030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOSTON THERAPY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-31
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty