Organization
GREYLOCK PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA J BAUMGART MPT (OWNER, PRESIDENT)
(413) 442-7007
Entity
Organization
Contact information
Practice address
31 WILLIAMSTOWN RD, LANESBORO, MA 01237-9603
(413) 442-7007
(413) 442-7011
Mailing address
P.O. BOX 1583, 31 WILLIAMSTOWN RD, LANESBORO, MA 01237-9603
(413) 442-7007
(413) 442-7011
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000038655
BMC HEALTHNET PLAN
—
01
—
40193
HEALTH NEW ENGLAND
—
01
—
637747
TUFTS HEALTH PLAN
—
01
—
6831785
CIGNA
—
01
—
9340087
AETNA
—
05
—
974781
—
MA
01
—
Y61482
BCBS PROVIDER NUMBER
MA
Enumeration date
03/20/2007
Last updated
03/29/2010
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