Organization
LAKEVILLE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN GIVINAL GOUVEIA PHYSICAL THERAPIST (PRESIDENT)
(508) 947-3004
Entity
Organization
Contact information
Practice address
155 MILLENNIUM CIR, SUITE 114, LAKEVILLE, MA 02347
(508) 947-3004
(508) 923-6008
Mailing address
155 MILLENNIUM CIR, SUITE 114, LAKEVILLE, MA 02347
(508) 947-3004
(508) 923-6008
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5869
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9739190
—
MA
01
—
AA20786
HPHC
MA
01
—
Y61391
BCBS
MA
Enumeration date
06/25/2007
Last updated
06/25/2008
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