Organization
VICTORY PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LUZARRAGA P.T. (PRESIDENT)
(617) 549-2640
Entity
Organization
Contact information
Practice address
35 SOLDIERS FIELD PL, BRIGHTON, MA 02135-1103
(617) 549-2640
Mailing address
10 COUNTRY CORNERS RD, WAYLAND, MA 01778-3606
(617) 549-2640
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011232
MEDICARE PTAN
MA
Enumeration date
06/05/2009
Last updated
07/15/2015
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