Organization
SOUTH SHORE PHYSIATRY AND SPASTICITY MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN KOELBEL MD (OWNER)
(617) 448-9303
Entity
Organization
Contact information
Practice address
250 POND STREET, BRAINTREE, MA 02184-5351
(781) 348-2202
Mailing address
132 ISLAND CREEK RD, DUXBURY, MA 02332-4323
(617) 448-9303
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110083193A
—
MA
01
—
M19641
BLUE CROSS MA
MA
Enumeration date
09/12/2008
Last updated
11/04/2024
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