Individual
MS. CAROL LYNN GILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
202 STATE RD, GREAT BARRINGTON, MA 01230-2502
(413) 717-0827
Mailing address
202 STATE RD, GREAT BARRINGTON, MA 01230-2502
(413) 717-0827
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
9538
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B00572514
BOSTON MEDICAL CENTER HEALTHNET PLAN
MA
Enumeration date
02/28/2011
Last updated
02/28/2011
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