Gateway Physical Therapy and Wellness Corp

Organization Active NPI Physical Therapist · Lee, MA

NPI 1194101048 · NPPES record last updated Feb 9, 2016

Key facts

NPI
1194101048
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
License
17639 (MA)
Legal business name
GATEWAY PHYSICAL THERAPY AND WELLNESS CORP
Practice address
80 Run Way
Lee, MA 01238-9612
Phone
(413) 243-3477
Fax
(413) 243-1630
NPI assigned
Aug 3, 2015
Organization subpart
No

Authorized official

Name
Rachel Welch, MSPT
Title
Owner/PT
Phone
(413) 243-3477

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151027002387 MA Part B Supplier - Clinic/Group Practice 8325357668 Receives reassigned benefits from 5 practitioners
Practice locations: Lee, MA

National Provider Directory

Locations

80 Run Way
Lee, MA 01238
Phone (413) 243-3477

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X 17639 MA Yes

Addresses

Primary practice location

80 Run Way
Lee, MA 01238-9612

Mailing address

80 Run Way
Lee, MA 01238-9612
Phone (413) 243-3477

Other providers in Lee, MA

All providers in Lee, MA · Physical Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.