Individual
PHILLIPS EDMUND NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
200 GOVERNORS AVE., MEDFORD, MA 02155
(781) 391-5400
Mailing address
8 DALTON RD, BELMONT, MA 02478-3724
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6078
MA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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