Individual
LAURA BRADBURY CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
75 FINNELL DR, WEYMOUTH, MA 02188-1110
(781) 335-1151
(781) 335-7851
Mailing address
1 CREDIT UNION WAY, FL. 3, RANDOLPH, MA 02368-4633
(781) 961-3370
(781) 961-1291
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20048
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003169401
MEDICARE PTAN
MA
Enumeration date
01/28/2013
Last updated
01/18/2018
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