Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 6492 | MA |
NPI | 1043369846 |
---|---|
Provider Name | Jean Anne Wright |
First Address | Mansfield, MA 02048-3256 |
Second Address | Quincy, MA 02171-3139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |