Provider Demographics
NPI:1841348273
Name:KING, LINDA WOLF (PT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:WOLF
Last Name:KING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15 OAK CT
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:MA
Mailing Address - Zip Code:02370-3337
Mailing Address - Country:US
Mailing Address - Phone:339-987-0220
Mailing Address - Fax:781-519-4757
Practice Address - Street 1:140 WOOD RD STE 405E
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2515
Practice Address - Country:US
Practice Address - Phone:781-519-4756
Practice Address - Fax:781-519-4757
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4176225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6400237OtherUNITED HEALTHCARE
MA307597OtherHARVARD PILGRIM HEALTHCAR
MA407500OtherTUFTS OUT OF NETWORK
MAY67471OtherBLUE CROSS BLUE SHIELD
MA407500OtherTUFTS OUT OF NETWORK