Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 3923 | MA |
NPI | 1013374263 |
---|---|
Provider Name | Katherine Cambra |
First Address | Buzzards Bay, MA 02532-5613 |
Second Address | Buzzards Bay, MA 02532-5613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2016 |
Last Update Date | 19/01/2016 |