Provider Demographics
NPI:1871733295
Name:PARADIS, JUSTIN PATRICK (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:PATRICK
Last Name:PARADIS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 LINDEN PONDS WAY
Mailing Address - Street 2:OP REHAB CLINIC
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-8714
Mailing Address - Country:US
Mailing Address - Phone:781-435-7160
Mailing Address - Fax:781-534-7382
Practice Address - Street 1:205 LINDEN PONDS WAY
Practice Address - Street 2:OP REHAB CLINIC
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-8714
Practice Address - Country:US
Practice Address - Phone:781-435-7160
Practice Address - Fax:781-534-7382
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist