Individual
MRS. ROGINA A MODESTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 MAPLE ST, EAST LONGMEADOW, MA 01028-2765
(413) 525-0367
Mailing address
36 BURLEIGH RD, HAMPDEN, MA 01036-9661
(413) 566-0286
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1214
MA
Other
Enumeration date
05/01/2011
Last updated
05/01/2011
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