Unknown Organization
NPI #1104639731 in Waltham, Massachusetts
Provider Information
- NPI Number
- 1104639731
- Entity Type
- Organization
- Organization Name
- Unknown Organization
- Primary Specialty
- Clinic/Center - Physical Therapy
- Enumeration Date
- Jan 28, 2025
- Last Updated
- Feb 9, 2025
Practice Location
- Address
- 40 CRESCENT ST STE 104
- City
- Waltham
- State
- Massachusetts
- ZIP Code
- 02453-4313
- Phone
- (781) 916-8825
Authorized Official
- Name
- YOLANDA ENID RODRIGUEZ, PTA
- Title
- PRESIDENT
- Phone
- (781) 916-8825
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Physical Therapy — Physical Therapy |
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