| NPI | 1053316182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA ROSE IGNASIAK Billing Manager 508-853-4590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 15249) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2015-08-12 |