Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 18637 | MA |
NPI | 1023242880 |
---|---|
Provider Name | Kenneth Scott Leaman |
First Address | Plymouth, MA 02360-1628 |
Second Address | Quincy, MA 02169-7335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 08/05/2009 |