Individual
LISA DACEY MADDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 642-0663
Mailing address
224 CHERRY ST, NEWTON, MA 02465-1246
(617) 823-9831
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19062
MA
Other
Enumeration date
05/03/2014
Last updated
05/03/2014
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