Individual
MRS. BONNIE LYN WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
32 HOSPITAL HILL RD, GARDNER, MA 01440-2302
(978) 632-5477
Mailing address
15 ROLLINGWOODS RD, HUBBARDSTON, MA 01452-1310
(978) 928-4782
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
648
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
648
PTA LICENSE SERIAL NUMBER
MA
Enumeration date
07/13/2007
Last updated
07/13/2007
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