Provider Demographics
NPI:1962963314
Name:RATHOD, KOMAL (MSPT)
Entity type:Individual
Prefix:
First Name:KOMAL
Middle Name:
Last Name:RATHOD
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 REDWOOD PATH
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1326
Mailing Address - Country:US
Mailing Address - Phone:508-834-2781
Mailing Address - Fax:
Practice Address - Street 1:121 NORTHBORO RD E
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1844
Practice Address - Country:US
Practice Address - Phone:508-485-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist