Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 18527 | MA |
NPI | 1073753430 |
---|---|
Provider Name | Christine M Tobin |
First Address | Westford, MA 01886-3131 |
Second Address | Westford, MA 01886-3131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2009 |
Last Update Date | 24/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18527 | STATE LICENSE NUMBER (01) | MA |