Organization
MEDWAY COUNTRY MANOR INC
Active
Parent organization
MEDWAY COUNTRY MANOR, INC.
Other names
Generations Outpatient Wellness & Rehab - Occupational Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDWAY COUNTRY MANOR, INC.
Authorized official
MR. JOHN PETERS III (TREASURER)
(508) 533-6634
Entity
Organization
Contact information
Practice address
115 HOLLISTON ST, MEDWAY, MA 02053-1954
(508) 533-9893
(508) 533-7048
Mailing address
115 HOLLISTON ST, MEDWAY, MA 02053-1954
(508) 533-9893
(508) 533-7048
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0840
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0910481
—
MA
Enumeration date
04/03/2008
Last updated
04/03/2008
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