Individual
LAUREL MARY BONACCORSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
865 CENTRAL AVE, NEEDHAM, MA 02492-1316
(781) 433-6655
Mailing address
97 ELLIS AVE, NORWOOD, MA 02062-3916
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5593
MA
Other
Enumeration date
09/06/2019
Last updated
09/06/2019
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