Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 22063 | MA |
NPI | 1003280413 |
---|---|
Provider Name | Miss Bryana Carey |
First Address | Boston, MA 02114-3117 |
Second Address | Boston, MA 02114-3117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2015 |
Last Update Date | 23/11/2015 |