Organization
NORTH SOUTH PHYSICAL THERAPY, INC
Active
Other names
Main Street Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP JOSEPH GAROFALO PTA (OWNER/DIRECTOR)
(508) 559-9696
Entity
Organization
Contact information
Practice address
95 MAIN ST, BROCKTON, MA 02301-4010
(508) 559-9696
(508) 559-9751
Mailing address
95 MAIN ST, BROCKTON, MA 02301-4010
(508) 559-9696
(508) 559-9751
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
124
MA
2251X0800X
Orthopedic Physical Therapist
Primary
124
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029723
NEIGHBORHOOD HEALTH
MA
01
—
7380356
AETNA
—
05
—
9786082
—
MA
01
—
AA9360
HARVARD PILGRIM HEALTH INSURANCE
MA
01
—
Y61200
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/23/2009
Last updated
06/23/2009
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