Individual
MARK HANSBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
564 MAIN ST, WALTHAM, MA 02452-5516
(781) 894-8880
Mailing address
564 MAIN ST, WALTHAM, MA 02452-5516
(781) 894-8880
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19972
MA
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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