Individual
DR. JARED MICHAEL FAGERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
940 BELMONT ST BLDG 2, BROCKTON, MA 02301-5568
(774) 826-1563
Mailing address
44 S GATE PARK, WEST NEWTON, MA 02465-1616
(952) 836-6298
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25734
MA
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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