Individual
LAISEE SCHIPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
105 RESEARCH RD, HINGHAM, MA 02043-4322
(781) 740-1808
Mailing address
17 FERNDALE AVE, PEMBROKE, MA 02359-2437
(781) 294-4461
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6142
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6142
PTA LICENSE
MA
Enumeration date
11/09/2018
Last updated
11/09/2018
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