Individual
JESSE TILDEN GREENSLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
316 HUNTINGTON AVE, BOSTON, MA 02115
(617) 449-7381
Mailing address
716 COLUMBIA RD APT 3L, BOSTON, MA 02125-1700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000025664
MA
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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