Individual
MRS. DIANE BOUTET KISZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
26 BRIDLE PATH LN, METHUEN, MA 01844-1570
(978) 685-3154
Mailing address
26 BRIDLE PATH LN, METHUEN, MA 01844-1570
(978) 685-3154
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3141
MA
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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