Individual
MRS. EILEEN SUPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
95 TREMONT ST, SUITE 20, DUXBURY, MA 02332-4738
(781) 934-7292
(781) 934-8112
Mailing address
12 STONEY BROOK RD, KINGSTON, MA 02364
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5794
MA
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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