Individual
BENJAMIN M GRUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
16 HAYDEN AVE, LEXINGTON, MA 02421-7929
(781) 372-7000
Mailing address
41 MALL RD, BURLINGTON, MA 01805-0001
(781) 744-8085
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13290
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MA
Enumeration date
01/29/2020
Last updated
01/29/2020
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