Individual
MRS. TRUDY ROSE RADVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(508) 583-4500
Mailing address
11 BETHANY LN, MATTAPOISETT, MA 02739-1073
(508) 758-6494
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1913
MA
Other
Enumeration date
06/26/2006
Last updated
07/08/2007
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