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Individual

MS. DANA M FANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, PT

Contact information

Practice address
2 POND PARK RD, SUITE 102, HINGHAM, MA 02043-4347
(781) 337-5555
(781) 335-6047
Mailing address
2 POND PARK RD, SUITE 102, HINGHAM, MA 02043-4347
(781) 337-5555
(781) 335-6047

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
15029
MA
363A00000X
Physician Assistant
Primary
AP2410
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
99510
FALLON
MA
Enumeration date
03/14/2006
Last updated
04/16/2014
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