Individual
THERESE CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10 VETERANS MEMORIAL DR, MILFORD, MA 01757-2900
(508) 473-6414
Mailing address
10 VETERANS MEMORIAL DR, MILFORD, MA 01757-2900
(508) 473-6414
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3464
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3464
COMMONWEALTH OF MA DIVISION OF PROFESSIONAL LICENSURE
MA
Enumeration date
04/17/2015
Last updated
04/17/2015
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