Organization
BACK AND BALANCE REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VYACHESLAV DENISHENKO (RESIDENT AGENT)
(617) 424-4749
Entity
Organization
Contact information
Practice address
665 BEACON ST, 400, BOSTON, MA 02215-3202
(617) 424-4760
Mailing address
665 BEACON ST, 400, BOSTON, MA 02215-3202
(617) 424-4760
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11124
MA
Other
Enumeration date
03/04/2009
Last updated
03/04/2009
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