Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

NPI 1104639731

Organization Physical Therapy Clinic/Center · NPI 1104639731

NPI 1104639731 is a Physical Therapy Clinic/Center in Waltham, Massachusetts. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

40 Crescent St Ste 104
Waltham, MA 02453-4313
Phone: (781) 916-8825
Fax: (781) 701-3570
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X

Record details

NPI number1104639731
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Yolanda Rodriguez — President · (781) 916-8825
NPI enumeratedJanuary 28, 2025
Last updated in NPPESFebruary 9, 2025
Certification dateFebruary 9, 2025
Mailing address40 Crescent St Ste 104, Waltham, MA 02453-4313

Other providers in Waltham