Provider Demographics
NPI:1386072403
Name:FUSION PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:FUSION PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-628-9169
Mailing Address - Street 1:PO BOX 838
Mailing Address - Street 2:
Mailing Address - City:WEST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02576-0838
Mailing Address - Country:US
Mailing Address - Phone:774-766-0440
Mailing Address - Fax:774-568-5613
Practice Address - Street 1:748 ASHLEY BLVD.
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745
Practice Address - Country:US
Practice Address - Phone:508-995-9000
Practice Address - Fax:774-568-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11199261QP2000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy