Organization
STAY ACTIVE PHYSICAL THERAPY AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALEEL ABDUL-JABBAAR (PHYSICAL THERAPIST)
(857) 204-6228
Entity
Organization
Contact information
Practice address
27 TACOMA ST, HYDE PARK, MA 02136-3203
(857) 204-6228
Mailing address
27 TACOMA ST, HYDE PARK, MA 02136-3203
(857) 204-6228
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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