Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 18692 | MA |
NPI | 1013140680 |
---|---|
Provider Name | John Dao-Tran |
First Address | Lowell, MA 01854-3126 |
Second Address | Lowell, MA 01854-3126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2009 |
Last Update Date | 31/08/2009 |