Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | MA6523 | MA |
NPI | 1003165630 |
---|---|
Provider Name | Mrs. Lori Ann Kipnes |
First Address | N Dartmouth, MA 02747-1221 |
Second Address | N Dartmouth, MA 02747-1221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2012 |
Last Update Date | 29/08/2012 |