| NPI | 1396097309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA A CLARK Owner 781-269-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: MA 11745) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: MA 19782) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: MA 6919) | |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2012-10-15 |