Basic Information
| Provider Information | |||||||||
| NPI: | 1619134749 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MILTON CHIRO AND REHAB INC | ||||||||
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| OtherOrganizationName: | BAY STATE PHYSICAL THERAPY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 WILLARD ST | ||||||||
| Address2: | SUITE GA | ||||||||
| City: | QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021691200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174715053 | ||||||||
| FaxNumber: | 6179840636 | ||||||||
| Practice Location | |||||||||
| Address1: | 1095 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | ATTLEBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027037944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087619000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2008 | ||||||||
| LastUpdateDate: | 05/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | WINDWER | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6174714491 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PT, DC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 213 | MA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.