Individual
MELISSA CROCKETT CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9 YARMOUTH PL, APT #3, BOSTON, MA 02116-5865
(617) 869-4193
Mailing address
9 YARMOUTH PL, APT #3, BOSTON, MA 02116-5865
(617) 869-4193
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7994
MA
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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