Provider Demographics
NPI:1700129616
Name:PHYSICAL THERAPY NETWORK LLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY NETWORK LLC
Other - Org Name:THE PHYSICAL THERAPY NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:E
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:781-326-1400
Mailing Address - Street 1:980 WASHINGTON ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-6731
Mailing Address - Country:US
Mailing Address - Phone:781-326-1400
Mailing Address - Fax:781-326-1488
Practice Address - Street 1:980 WASHINGTON ST
Practice Address - Street 2:SUITE 121
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6731
Practice Address - Country:US
Practice Address - Phone:781-326-1400
Practice Address - Fax:781-326-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8421261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy