Alex John Petruska is a Sports in Boston, Massachusetts. Alex John Petruska practices all healthcare services and medical treatments related to Sports. The NPI Number for Alex John Petruska is 1912930819. The last update date is 2007-07-08.
Alex John Petruska's current location address is 175 Cambridge St, Boston, Massachusetts. You can contact this provider via phone number 6176430912. The mailing address for Alex John Petruska is 175 Cambridge St, Boston, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Alex John Petruska |
|---|---|
| Address | 175 Cambridge St, Boston, Massachusetts |
| Phone Number | 6176430912 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PT |
NPI Number Detail
| NPI Number | 1912930819 |
|---|---|
| Provider Enumeration Date | 2006-07-07 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 175 Cambridge St |
|---|---|
| City | Boston |
| State | Massachusetts (MA) |
| Post Code | 21142743 |
| Phone Number | 6176430912 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Sports |
|---|---|
| Taxonomy | 2251S0007X |
| Licence No | 2874 |
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Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, patholog |
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What is the unique 10-digit identifier code issued to Alex John Petruska by the Centers for Medicare & Medicaid Services?
The Alex John Petruska has been assigned the NPI (National Provider Identifier) 1912930819 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Alex John Petruska is geographically located?
The Alex John Petruska is physically situated at the following location: 175 Cambridge St, Boston, MA, 21142743.
What is Alex John Petruska's specialized field of practice, and what is the corresponding taxonomy classification code?
The Alex John Petruska's area of specialization is Sports, and the corresponding taxonomy code that categorizes this field of practice is 2251S0007X.
On what date did the Alex John Petruska receive the assignment of its 1912930819 from the Centers for Medicare & Medicaid Services?
The Alex John Petruska was issued its 1912930819 by the Centers for Medicare & Medicaid Services on 2006-07-07.
As of what date was the information regarding Alex John Petruska, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Alex John Petruska, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
NPI Number: 1720081763
Address: 675 E Highway 60, Hardinsburg, KY