Individual
LORI CADDOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
564 MAIN ST, WALTHAM, MA 02452-5516
(781) 894-8880
(781) 894-1121
Mailing address
564 MAIN ST, WALTHAM, MA 02452-5516
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15447
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
469563
TUFTS PROVIDER #
MA
01
—
Y67851
BCBS PROVIDER #
MA
Enumeration date
11/22/2006
Last updated
02/17/2011
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