Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 19295 | MA |
N | 225100000X | Physical Therapist | 6625 | SC |
NPI | 1003125345 |
---|---|
Provider Name | Meghan D Doyle |
First Address | East Wareham, MA 02538-4840 |
Second Address | East Wareham, MA 02538-4840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2010 |
Last Update Date | 17/11/2015 |