Individual
MARY POBLETE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, C/NDT
Contact information
Practice address
4 MILITIA DR, SUITE 17, LEXINGTON, MA 02421-4737
(949) 395-7191
Mailing address
15 BEACON ST, APARTMENT 2, SOMERVILLE, MA 02143-4353
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
18735
MA
2251P0200X
Pediatric Physical Therapist
33190
CA
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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