Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 18521 | MA |
NPI | 1013271931 |
---|---|
Provider Name | Miss Lindsey Marie Wolfe |
First Address | Somerville, MA 02143-1518 |
Second Address | Woburn, MA 01801-1072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 25/06/2012 |