Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3149 | MA |
NPI | 1003261389 |
---|---|
Provider Name | Alison Caruso |
First Address | Hyannis, MA 02601-3922 |
Second Address | Hyannis, MA 02601-3922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2016 |
Last Update Date | 25/04/2016 |