Individual
MS. AIMEE JEANNE PTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
42 COOLIDGE AVE, WALTHAM, MA 02452-5744
(781) 929-5688
Mailing address
42 COOLIDGE AVE, WALTHAM, MA 02452-5744
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13214
MA
225100000X
Physical Therapist
36802
CA
225100000X
Physical Therapist
PT01487
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26564-9
BCBS
RI
01
—
406542
BLUE CHIP
RI
Enumeration date
05/30/2006
Last updated
10/14/2012
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