Provider Demographics
NPI:1962115956
Name:FLOWSTATE PHYSIOTHERAPY PLLC
Entity type:Organization
Organization Name:FLOWSTATE PHYSIOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NYSSA
Authorized Official - Middle Name:ROSINA
Authorized Official - Last Name:MIDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:618-559-6145
Mailing Address - Street 1:91 HARVEY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1774
Mailing Address - Country:US
Mailing Address - Phone:617-764-5205
Mailing Address - Fax:
Practice Address - Street 1:91 HARVEY ST STE 2
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1774
Practice Address - Country:US
Practice Address - Phone:617-764-5205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy