Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 12055 | MA |
Y | 2251X0800X | Physical Therapist - Orthopedic | 12055 | MA |
NPI | 1235361346 |
---|---|
Provider Name | Elizabeth Mckenna Reinach |
First Address | Westborough, MA 01581-3363 |
Second Address | Worcester, MA 01606-1167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2009 |
Last Update Date | 25/04/2011 |