| South Shore Sports & Muscular | |
|
90 Libbey Industrial Pkwy, Ste 103, East Weymouth, MA 02189-3129 | |
| (781) 331-9600 | |
| (781) 335-1556 |
| Full Name | South Shore Sports & Muscular |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist - Orthopedic |
| Location | 90 Libbey Industrial Pkwy, East Weymouth, Massachusetts |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104822576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | 5290 (Massachusetts) | Primary |
| Provider Name | Rebecca C Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699759084 PECOS PAC ID: 9335037522 Enrollment ID: I20040309000740 |
| Provider Name | Domenic F Sulfaro |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336250356 PECOS PAC ID: 8224028287 Enrollment ID: I20040513000439 |
| Provider Name | Gary C Kimball |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033102199 PECOS PAC ID: 1557332475 Enrollment ID: I20040804000717 |
| Provider Name | Travis E Schoen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215920384 PECOS PAC ID: 3678544509 Enrollment ID: I20040804000772 |
| Provider Name | Neil T Mcdermott |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649263674 PECOS PAC ID: 2567433394 Enrollment ID: I20040804000860 |
| Mailing Address | Practice Location Address |
|---|---|
| South Shore Sports & Muscular 90 Libbey Industrial Pkwy, Ste 103, East Weymouth, MA 02189-3129 Ph: (781) 331-9600 | South Shore Sports & Muscular 90 Libbey Industrial Pkwy, Ste 103, East Weymouth, MA 02189-3129 Ph: (781) 331-9600 |