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Individual

OLIVIA BEAUDETTE-BOUSQUET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1111 ELM ST, WEST SPRINGFIELD, MA 01089-1782
(413) 734-0300
Mailing address
1111 ELM ST STE 34, WEST SPRINGFIELD, MA 01089-1540
(413) 734-0107

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9858
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110026265E
MA
Enumeration date
03/29/2018
Last updated
09/23/2024
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