Organization
JVL INTERNATIONAL, INC
Active
Parent organization
JVL INTERNATIONAL, INC.
Other names
FYZICAL - Brockton
Organization subpart
Yes
Provider details
NPI number
Legal business name
JVL INTERNATIONAL, INC.
Authorized official
MR. JAMES VAN LAM (PRESIDENT)
(781) 666-4444
Entity
Organization
Contact information
Practice address
425 PLEASANT ST, 2ND FLOOR, BROCKTON, MA 02301-2533
(508) 510-5720
(508) 510-4237
Mailing address
PO BOX 4606, BROCKTON, MA 02303-4606
(508) 510-5720
(508) 510-4237
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
670
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7001000Y61642
BLUE CROSS BLUE SHIELD
MA
01
—
AA285366
HAVARD PILGRIM
MA
Enumeration date
05/11/2012
Last updated
02/22/2017
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