Individual
JESSICA SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
637 WASHINGTON STREET, SUITE 102, BROOKLINE, MA 02446
(617) 734-6135
(617) 734-3744
Mailing address
29 CRAFTS STREET, SUITE 570, NEWTON, MA 02458
(617) 965-8010
(617) 965-8071
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19301
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19301
PT LICENSE
MA
Enumeration date
04/15/2011
Last updated
11/19/2013
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