NPI | 1699964742 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL LOUIS PROVENZANO Owner 978-686-7111 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 18057) |
Enumeration Date | 2007-10-15 |
Last Update Date | 2008-07-03 |