Organization
CHAMPIONSHIP PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM J SQUIRES JR. PT (MANAGER)
(617) 846-5609
Entity
Organization
Contact information
Practice address
120 BANKS ST, WINTHROP, MA 02152
(617) 846-5609
(617) 539-0025
Mailing address
120 BANKS ST, WINTHROP, MA 02152
(617) 846-5609
(617) 539-0025
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0034886
NEIGHBORHOOD HEALTH
—
01
—
112846
AETNA
—
01
—
606436
HARVARD PILGRIM
—
01
—
6400011
UNITED HEALTHCARE
—
01
—
831662
TUFTS
—
01
—
9774548
MASSHEALTH
—
05
—
9774548
—
MA
01
—
DD2189
MEDICARE RR
—
Enumeration date
08/24/2006
Last updated
12/12/2007
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