Mobilives PT LLC

Organization Active NPI Physical Therapist · Richmond, MA

NPI 1750164091 · NPPES record last updated Aug 18, 2023

Key facts

NPI
1750164091
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
MOBILIVES PT LLC
Practice address
82 Pine Grove Dr
Richmond, MA 01254-5050
Phone
(413) 822-9456
NPI assigned
Aug 18, 2023
Organization subpart
No

Authorized official

Name
Tricia Wyatt, PT
Title
Member/Owner
Phone
(423) 822-9456

Practitioners 1

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
O20231020001407 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1850747247 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, MA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X Yes

Addresses

Primary practice location

82 Pine Grove Dr
Richmond, MA 01254-5050

Mailing address

82 Pine Grove Dr
Richmond, MA 01254-5050

Other providers in Richmond, MA

All providers in Richmond, MA · Physical Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.