Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3363 | MA |
NPI | 1003092735 |
---|---|
Provider Name | Ms. Susan Fellows Mcginley |
First Address | Natick, MA 01760-1701 |
Second Address | Natick, MA 01760-1701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2008 |
Last Update Date | 11/01/2008 |