Provider Demographics
NPI:1447247911
Name:DANCEWICZ, PAUL M (BS PT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:M
Last Name:DANCEWICZ
Suffix:
Gender:M
Credentials:BS PT
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Mailing Address - Street 1:1 LINEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2901
Mailing Address - Country:US
Mailing Address - Phone:978-356-4297
Mailing Address - Fax:978-356-5091
Practice Address - Street 1:1 LINEBROOK RD
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-2901
Practice Address - Country:US
Practice Address - Phone:978-356-4297
Practice Address - Fax:978-356-5091
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA4828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y68840Medicare ID - Type Unspecified