Individual
JAMIE LYN BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
361 NEWBURY ST, BOSTON, MA 02115-2727
(617) 302-6244
Mailing address
54 LUCIA DR, PITTSFIELD, MA 01201-8330
(413) 281-7848
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
16534
MA
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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