Impact Sports Lab

LBN: Impact Sports Lab
Impact Sports Lab is an health care organization with primary practice located at 220 W Cummings Park , Woburn MA 01801-6346. The organization recently has only one registered license in Ambulatory Health Care Facilities / Health Service, which is considered as the primary health care specialty. Impact Sports Lab can be contacted via phone (617) 549-6296, or through Carrera, Ian via phone (617) 549-6296.

Contact Information

Primary practice address
220 W Cummings Park Woburn MA 01801-6346
Phone: (617) 549-6296
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Carrera, Ian
Phone: (617) 549-6296

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Health Service 261QH0100X

Profile Details

NPI number 1922857432
LBN Legal business name Impact Sports Lab
DBA Doing business as
Authorized official Carrera, Ian
Entity Organization
Organization subpart 1 No
Enumeration date May 16th, 2024
Last updated May 16th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922857432 NPPES
Massachusetts MEDICAID 1285181552

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