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Individual

MR. JOHN WAYNE INACIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T., A.T.C.

Contact information

Practice address
214 N MAIN ST, SUITE 107, NATICK, MA 01760-1131
(508) 650-1856
(508) 653-9563
Mailing address
23 LIBERTY ST, NATICK, MA 01760-1245
(508) 647-2299

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4097
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0370797
MA
01
469186
TUFTS
MA
01
Y65359
MASSACHUSETTS BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/02/2005
Last updated
05/02/2008
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