Basic Information
| Provider Information | |||||||||
| NPI: | 1841314432 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TARENTINO | ||||||||
| FirstName: | MARIE | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | POTHIER | ||||||||
| OtherFirstName: | MARIE | ||||||||
| OtherMiddleName: | T | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MSPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8 TANGLEWOOD RD | ||||||||
| Address2: | SPORTS & WELLNESS PHYSICAL THERAPY | ||||||||
| City: | PLAINVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027625023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085285723 | ||||||||
| FaxNumber: | 5085285729 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 CHESTNUT ST | ||||||||
| Address2: | SPORTS & WELLNESS PHYSICAL THERAPY | ||||||||
| City: | FRANKLIN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020381271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085285723 | ||||||||
| FaxNumber: | 5085285729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 11/27/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 13280 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.