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Organization

ELM PARK PHYSICAL THERAPY LLC

Active
Other names
Dynamic Physical Therapy and Aquatic Rehab
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL BUSLOV PTA (OWNER)
(508) 799-6538
Entity
Organization

Contact information

Practice address
111 ELM ST, SUITE 103, WORCESTER, MA 01609-1967
(508) 799-6538
(508) 799-5535
Mailing address
111 ELM ST, SUITE 103, WORCESTER, MA 01609-1967
(508) 799-6538
(508) 799-5535

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Enumeration date
05/24/2011
Last updated
05/24/2011
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