Organization
STIM ATHLETIC THERAPY INC.
Active
Other names
Sports Center Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN JOSEPH BROCKLEBANK MPT (PRESIDENT AND PHYSICAL THERAPIST)
(508) 548-7491
Entity
Organization
Contact information
Practice address
33 HIGHFIELD DR, FALMOUTH, MA 02540-2303
(508) 548-7491
(508) 457-4907
Mailing address
PO BOX 593, FALMOUTH, MA 02541-0593
(508) 548-7491
(508) 457-4907
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
200
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
388229
EMDEON
—
Enumeration date
12/19/2006
Last updated
04/30/2008
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