Provider Demographics
NPI: | 1871125286 |
---|---|
Name: | HASSETT HEALTH & PHYSICAL THERAPY PLLC |
Entity type: | Organization |
Organization Name: | HASSETT HEALTH & PHYSICAL THERAPY PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ERIN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HASSETT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PT,DPT,OCS,FAAOMPT |
Authorized Official - Phone: | 708-334-3547 |
Mailing Address - Street 1: | 3520 N LAKE SHORE DR APT 2H |
Mailing Address - Street 2: | |
Mailing Address - City: | CHICAGO |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60657-1809 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3520 N LAKE SHORE DR APT 2H |
Practice Address - Street 2: | |
Practice Address - City: | CHICAGO |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60657-1809 |
Practice Address - Country: | US |
Practice Address - Phone: | 708-334-3547 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-02-04 |
Last Update Date: | 2020-02-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty |