Provider Demographics
NPI:1487963187
Name:MAJOR, SHAWN (PTA)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:MAJOR
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 WASHINGTON ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1046
Mailing Address - Country:US
Mailing Address - Phone:781-937-9777
Mailing Address - Fax:781-937-9767
Practice Address - Street 1:444 WASHINGTON ST
Practice Address - Street 2:SUITE 401
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1046
Practice Address - Country:US
Practice Address - Phone:781-937-9777
Practice Address - Fax:781-937-9767
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8149225200000X
NH0908225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant