Organization
MCGOVERN PHYSICAL THERAPY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN N DAVIDSON (CEO)
(616) 356-5000
Entity
Organization
Contact information
Practice address
350 MAIN ST, SUITE 205, MALDEN, MA 02148-5089
(781) 321-2727
(781) 321-4995
Mailing address
350 MAIN ST, SUITE 205, MALDEN, MA 02148-5089
(781) 321-2727
(781) 321-4995
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
9964
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0327328
—
MA
01
—
626293
HARVARD PROVIDER NUMBER
MA
01
—
687260
TUFTS
MA
05
—
9729861
—
MA
01
—
Y61240
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/26/2005
Last updated
12/11/2013
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