Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 25178 | MA |
NPI | 1083213409 |
---|---|
Provider Name | Kathryn A Piersiak |
First Address | Medfield, MA 02052-2317 |
Second Address | Medfield, MA 02052-2317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2020 |
Last Update Date | 19/10/2020 |