Individual
IAN AVENIA-TAPPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 AMHERST AVE, WALTHAM, MA 02451-3204
(860) 817-6315
Mailing address
20 AMHERST AVE, WALTHAM, MA 02451-3204
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20843
MA
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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