PT for Life LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

15884 Issued in MA

Legal business name

PT FOR LIFE LLC

Practice address

33 Union St
Manchester, MA 01944-1555

Phone

(617) 939-6794

NPI assigned

May 6, 2016

Last updated

May 6, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julie Crocker, DPT

Title

Owner/Physical Therapist

Phone

(617) 939-6794

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462492800000",
    "number": "1154777381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 NORWOOD AVE",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "019441507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UNION ST",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "019441555",
            "telephone_number": "617-939-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT FOR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-06",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "617-939-6794",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MA",
            "license": "15884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Neff, PSY.D.
• Casey O'Reilly, NP
• Matthew Orszulak, RDN, LDN
• Michael Piacentini, M.D.
• Dana Kelly Powers, D.D.S.
• Molly Regan, FNP-BC
• Heather Richard, PT
• Kathleen Salerno, NP
• Denise Sanson
• Louise Sarofeen, MS PT

• Physical Therapy Clinic/Center in Manchester, MA
• Providers in Manchester, MA by specialty
• Physical Therapy Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.