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1790925527
CHARLES ANTHONY INNISS
BOSTON, MA
NPI
1790925527
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MA 15232)
Enumeration Date
2009-03-06
Last Update Date
2009-03-06
Business Address
-- CHARLES ANTHONY INNISS DPT
654 BEACON ST
BOSTON, MA 02215-2099
Phone number: 617-536-1161
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Mailing Address
-- CHARLES ANTHONY INNISS DPT
654 BEACON ST
BOSTON, MA 02215-2099
Phone number: 617-536-1161
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