Provider Demographics
NPI:1457583528
Name:INTEGRATIVE BODYWORKS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:INTEGRATIVE BODYWORKS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:413-566-5025
Mailing Address - Street 1:71 THRESHER RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01036-9117
Mailing Address - Country:US
Mailing Address - Phone:413-566-0006
Mailing Address - Fax:
Practice Address - Street 1:2 ALLEN ST
Practice Address - Street 2:SUITE D
Practice Address - City:HAMPDEN
Practice Address - State:MA
Practice Address - Zip Code:01036-9552
Practice Address - Country:US
Practice Address - Phone:413-566-5025
Practice Address - Fax:413-566-3531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty