| Sport Station Adapted Exercises Corp | |
|
696 Washington St Apt 1 Holliston MA 01746-2186 | |
| (508) 663-6580 | |
| Not Available |
| Full Name | Sport Station Adapted Exercises Corp |
|---|---|
| Speciality | Behavior Analyst |
| Location | 696 Washington St Apt 1, Holliston, Massachusetts |
| Authorized Official Name and Position | Camila Goncalves De Assis (OWNER) |
| Authorized Official Contact | 5086636580 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sport Station Adapted Exercises Corp 696 Washington St Apt 1 Holliston MA 01746-2186 Ph: (508) 663-6580 | Sport Station Adapted Exercises Corp 696 Washington St Apt 1 Holliston MA 01746-2186 Ph: (508) 663-6580 |
| NPI Number | 1568275907 |
|---|---|
| Provider Enumeration Date | 01/29/2025 |
| Last Update Date | 01/29/2025 |
| Certification Date | 01/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568275907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
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