Provider Demographics
NPI:1992136337
Name:BICKFORD, CAROL (MSPT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BICKFORD
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 1:37 BROADWAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-5552
Mailing Address - Country:US
Mailing Address - Phone:781-643-6090
Mailing Address - Fax:781-643-7395
Practice Address - Street 1:37 BROADWAY
Practice Address - Street 2:SUITE 2
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-5552
Practice Address - Country:US
Practice Address - Phone:781-643-6090
Practice Address - Fax:781-643-7395
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8925225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist