Provider Demographics
NPI:1396177267
Name:MERRIMACK VALLEY PHYSICAL THERAPY
Entity type:Organization
Organization Name:MERRIMACK VALLEY PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRE
Authorized Official - Middle Name:
Authorized Official - Last Name:XINTAROPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:781-727-8897
Mailing Address - Street 1:225 ESSEX ST
Mailing Address - Street 2:1E
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1553
Mailing Address - Country:US
Mailing Address - Phone:781-727-8897
Mailing Address - Fax:781-938-1226
Practice Address - Street 1:225 ESSEX ST
Practice Address - Street 2:1E
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1553
Practice Address - Country:US
Practice Address - Phone:978-208-0402
Practice Address - Fax:781-938-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy