OrganizationActive
360 Neuromuscular Therapy, LLC
NPI 1700198306 · Massage Therapist · Waltham, MA
Provider details
- NPI number
- 1700198306
- Entity type
- Organization
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Lisa Erickson Gorman, Co-Owner(781) 444-3609
- License
- 167 (MA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1077 Lexington St Ste 202
Waltham, MA 02452-7233
Phone: (781) 444-3609
Fax: (781) 209-7301
Approximate (ZIP-level) locationGet directions
Mailing address
1077 Lexington St Ste 202
Waltham, MA 02452-7233
Registry dates
- Enumerated
- 2010-07-12
- Last updated
- 2019-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.