Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 8273 | MA |
NPI | 1003191446 |
---|---|
Provider Name | Caitlin Macdonald Grant |
First Address | North Adams, MA 01247-3620 |
Second Address | North Adams, MA 01247-3580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2011 |
Last Update Date | 17/10/2011 |