Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1548342926 |
---|---|
Provider Name | Jeffrey Dawes |
First Address | North Attleboro, MA 02760-3923 |
Second Address | Brockton, MA 02301-5596 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |