Individual
DANIEL JOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Contact information
Practice address
1 PEARL ST, STE 1700, BROCKTON, MA 02301-2864
(508) 427-0525
(774) 223-5017
Mailing address
1 CREDIT UNION WAY, FL. 3, RANDOLPH, MA 02368-4633
(781) 961-3370
(781) 961-1291
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
22237
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110114582A
MASSHEALTH PROVIDER IDENTIFICATION NUMBER
MA
01
—
S4003007859
MEDICARE PTAN
MA
Enumeration date
01/07/2016
Last updated
10/05/2016
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