Individual
DR. MARCO MATTEO BALASSONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
464 MAIN ST, AGAWAM, MA 01001-1826
(860) 794-8719
Mailing address
1931 CAM FELLA ST SE, ALBUQUERQUE, NM 87123-2393
(860) 794-8719
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24033
MA
225100000X
Physical Therapist
4725
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609244185
—
NM
Enumeration date
09/14/2015
Last updated
01/29/2019
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