Organization
BACKSTAGE PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER L BREEN II MSPT (MANAGING MEMBER)
(617) 254-1656
Entity
Organization
Contact information
Practice address
300 WESTERN AVE, BOSTON, MA 02134-1030
(617) 254-1656
Mailing address
300 WESTERN AVE, BOSTON, MA 02134-1030
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
15855
MA
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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