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Individual

THOMAS WILLIAM O'DONNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
150 SOUTH HUNTINGTON AVE, BOSTON, MA 02130
(617) 232-9500
(857) 364-4537
Mailing address
59 STOCKHOLM AVE, ROCKPORT, MA 01966-1276
(978) 546-7750

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CPO 1633
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
V130213
ORTHOTIST
MA
01
V130214
PROSTHETIST
MA
Enumeration date
08/31/2006
Last updated
07/08/2007
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