Organization
REVERE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PRUM (OWNER)
(781) 284-8277
Entity
Organization
Contact information
Practice address
76 SHIRLEY AVE, REVERE, MA 02151-5102
(781) 284-8277
Mailing address
76 SHIRLEY AVE, REVERE, MA 02151-5102
(781) 284-8277
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
343
MA
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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