Provider Demographics
NPI:1962106088
Name:JOHN REILLY PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:JOHN REILLY PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:781-706-7574
Mailing Address - Street 1:520 BOSTON PROVIDENCE TPKE STE 8
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-4946
Mailing Address - Country:US
Mailing Address - Phone:781-786-2716
Mailing Address - Fax:781-255-0394
Practice Address - Street 1:520 BOSTON PROVIDENCE TPKE STE 8
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-4946
Practice Address - Country:US
Practice Address - Phone:781-786-2716
Practice Address - Fax:781-255-0394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy