Basic Information
| Provider Information | |||||||||
| NPI: | 1972816486 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EHLE | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 CAMBRIDGE ST | ||||||||
| Address2: | C/O ORTHOPAEDICS PLUS | ||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018033766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812298011 | ||||||||
| FaxNumber: | 7812298374 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 CUMMINGS CTR | ||||||||
| Address2: | SUITE 121Q | ||||||||
| City: | BEVERLY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019156115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789270907 | ||||||||
| FaxNumber: | 9789270537 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2010 | ||||||||
| LastUpdateDate: | 04/26/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 19146 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.