Jason Lou, | |
110 Liberty St, Brockton, MA 02301-5674 | |
(508) 565-3055 | |
Not Available |
Full Name | Jason Lou |
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Gender | Male |
Speciality | Physical Medicine & Rehabilitation - Sports Medicine |
Location | 110 Liberty St, Brockton, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649621442 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 036.150868 (Illinois) | Secondary |
2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | 291672 (Massachusetts) | Primary |
Entity Name | Signature Healthcare Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508804949 PECOS PAC ID: 7719876267 Enrollment ID: O20040312000372 |
Mailing Address | Practice Location Address |
---|---|
Jason Lou, 110 Liberty St Ste 505, Brockton, MA 02301-5674 Ph: (508) 565-3055 | Jason Lou, 110 Liberty St, Brockton, MA 02301-5674 Ph: (508) 565-3055 |
Susan Diver, RPT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 215 Thatcher St, Brockton, MA 02302 Phone: 508-583-5834 | |
Dr. Tara Samantha Swim, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 110 Liberty St, Brockton, MA 02301 Phone: 508-565-3055 Fax: 508-894-0757 | |
Meredith Celine Harrington, ATC Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 110 Liberty St, Brockton, MA 02301 Phone: 508-941-7000 | |
Dr. John Alexander Wallington, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 110 Liberty St, Brockton, MA 02301 Phone: 508-565-3055 Fax: 508-894-0757 | |
Jerry Chi Chuan Fang, MD Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 110 Liberty St, Brockton, MA 02301 Phone: 508-894-0400 | |
Rosealiza Wan Zaid, DPT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 425 Pleasant St Ste 202, Brockton, MA 02301 Phone: 508-640-5000 | |
Emily Lane Carney, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 940 Belmont St, Brockton, MA 02301 Phone: 508-583-4500 |