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Individual

EDWARD T WILLETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
30 GLENNIE ST, WORCESTER, MA 01605-3917
(508) 791-8740
(508) 752-3716
Mailing address
30 GLENNIE ST, WORCESTER, MA 01605-3917
(508) 791-8740
(508) 752-3716

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2140
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0318701
MD
01
328820
CIGNA
MA
01
468025
TUFTS
MD
01
626330
HARVARD PILGRIM
MA
01
64029
AETNA
MA
01
981075
NETWORK HEALTH
MA
01
Y65047
BLUE CROSS
MA
Enumeration date
08/31/2006
Last updated
10/16/2010
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