Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 7078 | MA |
NPI | 1215575089 |
---|---|
Provider Name | Mrs. Nancy Kathleen Miller |
First Address | North Andover, MA 01845-5076 |
Second Address | North Andover, MA 01845-5076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2019 |
Last Update Date | 12/12/2019 |