Provider Demographics
NPI:1801591623
Name:MAGUIRES LYMPHEDEMA AND FOOT CARE
Entity type:Organization
Organization Name:MAGUIRES LYMPHEDEMA AND FOOT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/L, CLWT
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS
Authorized Official - Phone:978-621-2877
Mailing Address - Street 1:179 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01543-1614
Mailing Address - Country:US
Mailing Address - Phone:978-621-2877
Mailing Address - Fax:978-894-7658
Practice Address - Street 1:179 GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:MA
Practice Address - Zip Code:01543-1614
Practice Address - Country:US
Practice Address - Phone:978-621-2877
Practice Address - Fax:978-894-7658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty