Individual
JESSICA ROTHWELL RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., P.T.
Contact information
Practice address
76 SHIRLEY AVE, REVERE, MA 02151-5102
(781) 284-8277
Mailing address
39 SHORE AVE, QUINCY, MA 02169-2441
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11496
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0322849
MASS HEALTH PROVIDER NUMB
MA
Enumeration date
12/12/2006
Last updated
08/30/2021
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