Organization
PERFORMING ARTS PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA CAMPBELL (PT OWNER)
(617) 277-1500
Entity
Organization
Contact information
Practice address
1093 BEACON ST, BASEMENT SUITE, BROOKLINE, MA 02446
(617) 277-1500
(617) 277-1503
Mailing address
2 MAYFLOWER RD, WINCHESTER, MA 01890
(617) 277-1500
(617) 277-1503
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y61406
BCBS
MA
Enumeration date
02/02/2006
Last updated
08/22/2020
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