Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 18216 | MA |
NPI | 1003060526 |
---|---|
Provider Name | Mr. Edward David Segel |
First Address | Brookline, MA 02446-2463 |
Second Address | Brookline, MA 02446-2463 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2008 |
Last Update Date | 03/06/2021 |