Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 2701 | MA |
NPI | 1033515135 |
---|---|
Provider Name | Alice Hooper |
First Address | Bridgewater, MA 02324-1964 |
Second Address | Bridgewater, MA 02324-1964 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2014 |
Last Update Date | 17/11/2014 |