Organization
NANTUCKET THERAPY, LLC
Active
Other names
Nantucket Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
CARYNNE A KEYES MA, CCC-SLP (OWNER/DIRECTOR)
(508) 648-8348
Entity
Organization
Contact information
Practice address
125 ORANGE ST, NANTUCKET, MA 02554-4028
(508) 648-8348
(508) 796-6262
Mailing address
125 ORANGE ST, NANTUCKET, MA 02554-4028
(508) 648-8348
(508) 796-6262
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8082
MA
261QP2000X
Physical Therapy Clinic/Center
8216
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031240
PTAN
MA
05
—
110094575A
—
MA
Enumeration date
01/10/2014
Last updated
09/19/2014
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