Organization
SPORT LIFE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL MCMAHAN MSPT (OWNER)
(508) 577-2279
Entity
Organization
Contact information
Practice address
21 VINE ST, HOLLISTON, MA 01746-2311
(508) 577-2279
Mailing address
21 VINE ST, HOLLISTON, MA 01746-2311
(508) 577-2279
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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