| NPI | 1285082701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH A RUSSO Owner 617-964-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |