Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | PT295312 | CA |
Y | 225100000X | Physical Therapist | 24557 | MA |
NPI | 1013541796 |
---|---|
Provider Name | Linda Ream |
First Address | Randolph, MA 02368-4821 |
Second Address | Randolph, MA 02368-4821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2020 |
Last Update Date | 28/07/2020 |