Individual
KUYIK ETIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11 CONDITO RD, HINGHAM, MA 02043-1746
(781) 749-4774
Mailing address
100 FOREST AVE, BROCKTON, MA 02301-5910
(617) 974-7016
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8916
MA
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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