Provider Demographics
NPI:1053743211
Name:BD PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:BD PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-961-4460
Mailing Address - Street 1:63 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4862
Mailing Address - Country:US
Mailing Address - Phone:781-961-4460
Mailing Address - Fax:781-986-3650
Practice Address - Street 1:63 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4862
Practice Address - Country:US
Practice Address - Phone:781-961-4460
Practice Address - Fax:781-986-3650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy