NPI Provider: 1639176621
Contact Name: fahey L timothy
Position: occupational therapist
Phone: (978) 796-3002
Usarmy Information:
Usarmy organization have npi 1639176621, taxonomy code is 302F00000X with license number is 6741 in . This Business address located in 4 Newfield St, Leicester, MA 15241 Massachusetts.
Practice Location
Address: 4 Newfield St, Leicester, MA 15241
Phone: (508) 954-0943
Business Location
Address: 4 Newfield St, Leicester, MA 15241
Phone: (508) 954-0943
Fax: (585) 244-1374
Taxonomy
Taxonomy Code: 302F00000X
License Number: 6741
License Number of State: MA
Primary Taxonomy Switch: Y
Enumeration Date: 7/5/2005
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