Organization
KENNEDY BROTHERS PHYSICAL THERAPY INC.
Active
Other names
Kennedy Brothers Physical Therapy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA J COLLINS (ADMINISTRATOR)
(617) 372-6317
Entity
Organization
Contact information
Practice address
85 MAIN ST, STE 103, WATERTOWN, MA 02472
(617) 924-5100
(617) 924-5199
Mailing address
85 MAIN ST, STE 103, WATERTOWN, MA 02472
(617) 924-5100
(617) 924-5199
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000Y65622
BCBS PIN
MA
01
—
605690
HARVARD PILGRIM PIN
MA
01
—
717236
TUFTS PIN
MA
Enumeration date
11/28/2006
Last updated
06/25/2024
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