Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 9452 | MA |
NPI | 1124551122 |
---|---|
Provider Name | Janet Pelletti |
First Address | Worcester, MA 01604-2737 |
Second Address | Worcester, MA 01604-2737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2017 |
Last Update Date | 06/04/2017 |