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Organization
PROEX PHYSICAL THERAPY, LLC
Active
Organization
PROEX PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRI WILKINSON (MANAGER OF CREDENTIALING)
(631) 359-5589
Entity
Organization
Contact information
Practice address
300 TRADE CENTER, SUITE 1650, WOBURN, MA 01801
(781) 935-2655
(781) 395-9097
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y61376
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/04/2005
Last updated
08/15/2022
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