Provider Demographics
NPI:1841314432
Name:TARENTINO, MARIE T (MSPT)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:T
Last Name:TARENTINO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:MARIE
Other - Middle Name:T
Other - Last Name:POTHIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:8 TANGLEWOOD RD
Mailing Address - Street 2:SPORTS & WELLNESS PHYSICAL THERAPY
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-5023
Mailing Address - Country:US
Mailing Address - Phone:508-528-5723
Mailing Address - Fax:508-528-5729
Practice Address - Street 1:800 CHESTNUT ST
Practice Address - Street 2:SPORTS & WELLNESS PHYSICAL THERAPY
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-1271
Practice Address - Country:US
Practice Address - Phone:508-528-5723
Practice Address - Fax:508-528-5729
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist