Individual
LUANN M FITZGERALD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
135 N BEACON ST, WATERTOWN, MA 02472-2751
(617) 926-8720
(617) 926-8920
Mailing address
135 N BEACON ST, WATERTOWN, MA 02472-2751
(617) 926-8720
(617) 926-8920
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6312
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0389943
—
MD
01
—
760390/FITZGERA
TUFTS HEALTH PLAN
MA
01
—
Y65404
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/03/2006
Last updated
07/08/2007
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