VANTAGE SPORTS AND REHAB, LLC (NPI# 1770814089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770814089 |
| Entity Type | Organization |
| Organization Name | VANTAGE SPORTS AND REHAB, LLC |
| Practice Address |
1581 N Main St Palmer MA 01069-1232 |
| Practice Telephone | 4132838303 |
| Practice Fax Number | 4138238304 |
| Mailing Telephone | 4132838303 |
| Mailing Fax Number | 4138238304 |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2012-11-21 |
| Authorized Official Name | DR. DMITRY VOLOSHINOV (OWNER/PHYSICAL THERAPIST) |
| Authorized Official Telephone | 4132838303 |
| Authorized Official Credential | DPT, STS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
1581 N MAIN ST |
| City | PALMER |
| State | MA |
| Zip Code | 01069-1232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275593741 | Rebecca J. Wing | Physical Therapist | 1581 N Main St, Palmer, MA 01069-1232 | 2006-03-27 |
| 1215589429 | Kaitlin Elizabeth Foley | Developmental Therapist | 1581 N Main St, Palmer, MA 01069-1232 | 2019-07-09 |
| 1720551757 | Liane Mary Martin | Occupational Therapist | 1581 N Main St, Palmer, MA 01069-1232 | 2019-01-02 |
| 1588144455 | Maura Chlebus | Speech-Language Pathologist | 1581 N Main St, Palmer, MA 01069-1232 | 2018-08-20 |
| 1922517630 | Laura Jane Outhuse | Occupational Therapist | 1581 N Main St, Palmer, MA 01069-1232 | 2017-09-26 |
| 1528431996 | Jared Nykiel | Physical Therapist | 1581 N Main St, Palmer, MA 01069-1232 | 2015-11-07 |
| 1518343698 | Helen Wood | Behavioral Analyst | 1581 N Main St, Palmer, MA 01069-1232 | 2015-07-30 |
| 1821401217 | Kelli Correia | Health Educator | 1581 N Main St, Palmer, MA 01069-1232 | 2014-06-04 |
| 1992121222 | Kelly Blaney | Developmental Therapist | 1581 N Main St, Palmer, MA 01069-1232 | 2014-03-11 |
| 1447676051 | Criterion Child Enrichment | Early Intervention Provider Agency | 1581 N Main St, Palmer, MA 01069-1232 | 2014-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962979328 | Jacqueline Pahl | Social Worker | 11 Oakland St., Palmer, MA 01069 | 2018-10-24 |
| 1891277240 | Katherine Beliveau | Developmental Therapist | 1581 N. Main Street, Palmer, MA 01069 | 2018-09-02 |
| 1730606740 | Jordan Elizabeth Pike | Physician Assistant | 40 Wirght, Palmer, MA 01069 | 2017-08-30 |
| 1265880405 | Brittany Ford | Specialist/Technologist | 4105 Main St, Palmer, MA 01069 | 2016-05-27 |
| 1417263021 | Deborah Lee Stroetzel I | Audiologist-Hearing Aid Fitter | 40 Wright St., Palmer, MA 01069 | 2010-08-20 |
| 1063635399 | Department of Developmental Services | Intermediate Care Facility, Mentally Retarded | Monson Dev Cntr, 175 State Ave, Palmer, MA 01069 | 2007-04-11 |
| 1124149273 | Pruushotam Puri | Surgery | Wright Street, Palmer, MA 01069 | 2007-04-03 |
| 1679582019 | Richard Michael Gondek | Dentist | 1436 Main St, Palmer, MA 01069 | 2006-08-05 |
| 1083649222 | Jessica R Senecal-bennett | Social Worker | 42 Wright St, Palmer, MA 01069 | 2006-07-12 |
| 1396770632 | Daniel Shapiro | Social Worker | Wing Memorial Hospital Griswold Center, 40 Wright Street, Palmer, MA 01069 | 2006-07-12 |
| Find all providers in zip 01069 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871145995 | Recovery Waters Physical Therapy LLC | Clinic/Center | 9131 E Frontage Rd Ste 1, Palmer, AK 99645-9318 | 2019-07-09 |
| 1952604910 | Aurora Kid, LLC | Clinic/Center | 7335 East Palmer-wasilla Highway, Suite 1a, Palmer, AK 99645 | 2010-12-14 |
| 1821254814 | Simar Physical Therapy Services, LLC | Clinic/Center | 7335 E Palmer-wasilla Hwy, Suite 1c, Palmer, AK 99645 | 2008-07-30 |
| 1265525836 | Body In Balance Physical Therapy Inc | Clinic/Center | 642 S Alaska St Ste 209, Palmer, AK 99645-6378 | 2006-10-02 |
| 1841243573 | Excel Physical Therapy Limited | Clinic/Center | 809 S Chugach St, Suite 1, Palmer, AK 99645-6605 | 2006-05-17 |
| 1790320166 | Freedom Physical Therapy and Wellness LLC | Clinic/Center | 9665 E Trennie Loop Unit 4, Palmer, AK 99645-9165 | 2019-11-08 |
| 1124465539 | New Vibrations LLC | Clinic/Center | 1901 N Hemmer Rd, Ste 209, Palmer, AK 99645 | 2013-05-24 |
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|---|---|---|---|---|
| 1013518448 | Shira Lauren Dragun | Clinic/Center | 63 1/2 Jefferson Ave, Salem, MA 01970-2975 | 2020-11-03 |
| 1518564566 | Ann Pappas Physical Therapy | Clinic/Center | 470 Washington St Ste 31, Norwood, MA 02062-2343 | 2020-10-02 |
| 1538786272 | Neurologic Optimal Wellness Physical Therapy LLC | Clinic/Center | 180 King St, Springfield, MA 01109-4316 | 2020-06-29 |
| 1689297525 | Full Spectrum Physical Therapy and Performance, LLC | Clinic/Center | 17 Cannongate Rd Apt 83, Tyngsboro, MA 01879-1413 | 2020-05-27 |
| 1992328421 | Adam Auto Accident Physio Doctor,inc | Clinic/Center | 1011 Beacon St Ste 1, Brookline, MA 02446-5696 | 2020-05-19 |
| 1952938839 | Jessica Moy Wellness LLC | Clinic/Center | 255 Massachusetts Ave Apt 204, Boston, MA 02115-3511 | 2020-03-23 |
| 1598390940 | The Method Performance and Physical Therapy LLC | Clinic/Center | 378 North St Apt 2, Boston, MA 02113-2143 | 2020-03-05 |
| 1104458785 | Olender Physical Therapy, LLC | Clinic/Center | 316 Washington St Ste 1, Wellesley, MA 02481-4959 | 2020-02-11 |
| 1851930028 | Core Physical Therapy & Performance, LLC | Clinic/Center | 11 Randolph Rd, Randolph, MA 02368-4321 | 2020-01-05 |
| 1316585482 | Healthworks Med Group of Massachusetts P C | Clinic/Center | 157 Berkeley St, Boston, MA 02116-5108 | 2019-12-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.