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Organization
OLYMPIC PHYSICAL MEDICINE
Active
Organization
OLYMPIC PHYSICAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS E WHITE MSPT, LATC, CSCS (PRESIDENT)
(617) 666-8800
Entity
Organization
Contact information
Practice address
200 MAIN STREET, 111, STONEHAM, MA 02180-1619
(617) 666-8800
(617) 666-4488
Mailing address
200 MAIN STREET, 111, STONEHAM, MA 02180-1619
(617) 666-8800
(617) 666-4488
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
Primary
—
NULL
2251S0007X
Sports Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
NULL
2251X0800X
Orthopedic Physical Therapist
—
—
2255A2300X
Athletic Trainer
—
NULL
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
06/29/2006
Last updated
04/20/2008
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