Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 10140 | MA |
NPI | 1790926681 |
---|---|
Provider Name | Ms. Rachael Grace |
First Address | Ashland, MA 01721-3904 |
Second Address | Natick, MA 01760-3758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2009 |
Last Update Date | 16/04/2009 |