Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 6128 | MA |
NPI | 1033100656 |
---|---|
Provider Name | Mrs. Jodi A Llacera Klein |
First Address | Manchester, MA 01944-1468 |
Second Address | Manchester, MA 01944-1468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 08/07/2007 |