Organization
PERFORMANCE REHABILITATION OF WESTERN NEW ENGLAND LLC
Active
Other names
ATI Physical Therapy of Western Massachusetts
Organization subpart
No
Provider details
NPI number
Authorized official
WADE A MEYER (VP CHIEF COMPLIANCE OFFICER)
(630) 296-2222
Entity
Organization
Contact information
Practice address
300 BIRNIE AVE, SUITE 304, SPRINGFIELD, MA 01107
(413) 781-1054
(413) 439-0026
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
MA
2251H1200X
Hand Physical Therapist
—
MA
225X00000X
Occupational Therapist
Primary
—
MA
225XH1200X
Hand Occupational Therapist
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000035257
BOSTON MEDICAL CENTER
MA
01
—
043527
CT CARE
MA
01
—
103355100
DEPT OF LABOR
MA
01
—
28117
HNE
MA
01
—
64-04290
UNITED
MA
01
—
690675
TUFTS
MA
05
—
9715668
—
MA
01
—
972730
NETWORK HEALTH
MA
01
—
OG0011
BLUE SHIELD OT
MA
01
—
Y61264
BLUE SHIEL PT
MA
Enumeration date
09/11/2007
Last updated
10/31/2024
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