Organization
BOSTON REGIONAL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS FIESE PT (OWNER/PT)
(617) 296-9600
Entity
Organization
Contact information
Practice address
1659 BLUE HILL AVE, 2ND FLOOR, MATTAPAN, MA 02126-2107
(617) 296-9600
Mailing address
1659 BLUE HILL AVE, 2ND FLOOR, MATTAPAN, MA 02126-2107
(617) 296-9600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
59
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FI Y69545
—
MA
Enumeration date
09/02/2009
Last updated
09/02/2009
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