Individual
JOSEANE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
24 PERRAULT RD, SUITE 5, NEEDHAM, MA 02494-3288
(601) 941-8138
Mailing address
24 PERRAULT RD, SUITE 5, NEEDHAM, MA 02494-3288
(601) 941-8138
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10154
CT
225100000X
Physical Therapist
PT 5002
MS
225100000X
Physical Therapist
PTL.0012960
CO
Other
Enumeration date
08/16/2015
Last updated
08/17/2015
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