Khampasong Haleudeth
Physical Therapist in Medford, Massachusetts
1992475081- Practice location
- 275 Mystic Ave Ste C, Medford, MA 02155-6301
- Phone
- 781-874-9294
- Fax
- —
- Last updated
- September 20, 2021
Khampasong Haleudeth is a Physical Therapist based in Medford, MA. Khampasong Haleudeth practices in Medford, MA. The NPI Number for Khampasong Haleudeth is 1992475081 and holds a License No. 25676 (MA). The current practice location address for Khampasong Haleudeth is 275 Mystic Ave Ste C, Medford, MA 02155-6301 and can be reached out via phone at 781-874-9294.
Provider Profile Details
- NPI Number
- 1992475081
- Provider Name
- Khampasong Haleudeth
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 275 Mystic Ave Ste C, Medford, MA 02155-6301
- Phone Number
- 781-874-9294
- Primary Taxonomy
- Physical Therapist · 225100000X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 20, 2021
- Last Update Date
- September 20, 2021
- Certification Date
- September 20, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 275 Mystic Ave Ste C
Medford, MA 02155-6301 - City
- Medford
- State
- Massachusetts
- Zip
- 02155-6301
- Phone Number
- 781-874-9294
Provider Business Mailing Address Details
- Address
- 275 Mystic Ave Ste C
Medford, MA 02155-6301 - City
- Medford
- State
- MA
- Zip
- 02155-6301
License Information
- License Number
- 25676
- License State
- MA
- Taxonomy
- Physical Therapist · 225100000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Khampasong Haleudeth?
The NPI number of Khampasong Haleudeth is 1992475081. It was assigned on September 20, 2021 and is currently active in the NPPES registry.
What is the specialty of Khampasong Haleudeth?
Khampasong Haleudeth is registered under the primary taxonomy Physical Therapist (code 225100000X), licensed in MA under license number 25676.
Where does Khampasong Haleudeth practice?
The practice location is 275 Mystic Ave Ste C, Medford, MA 02155-6301. The office can be reached at 781-874-9294 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1992475081 directly on the NPPES registry website.