Organization
PROBODY PHYSICAL THERAPY, LLC
Active
Parent organization
PROBODY PHYSICAL THERAPY, LLC
Other names
ProBody Physical Therapy, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROBODY PHYSICAL THERAPY, LLC
Authorized official
DR. PAOLA JAAR DPT (DPT/OWNER)
(617) 331-3163
Entity
Organization
Contact information
Practice address
265 MEDFORD ST, SUITE 303, SOMERVILLE, MA 02143-1963
(617) 331-3163
Mailing address
265 MEDFORD ST, SUITE 303, SOMERVILLE, MA 02143-1963
(617) 331-3163
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
16357
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0322377
—
MA
01
—
JA Y69549
MEDICARE PROVIDER IDENIFICATION NUMBER
MA
Enumeration date
07/01/2012
Last updated
11/21/2012
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