Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 475 | MA |
Y | 213ES0000X | Sports Medicine | 475 | MA |
NPI | 1073157137 |
---|---|
Provider Name | Linda Boerger |
First Address | Uxbridge, MA 01569-1628 |
Second Address | Uxbridge, MA 01569-1628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2019 |
Last Update Date | 01/11/2019 |