Individual
JACLYN PONTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7212
Mailing address
101 MONMOUTH ST APT 511, BROOKLINE, MA 02446-5612
(201) 788-6979
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
047185-01
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25407
MA
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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