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Individual

LEONARD MACRINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
110 CLEMATIS AVE, SUITE 2, WALTHAM, MA 02453-7013
(617) 992-2984
Mailing address
110 CLEMATIS AVE, SUITE 2, WALTHAM, MA 02453-7013
(617) 992-2984

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PTH4256
AL
2251S0007X
Sports Physical Therapist
Primary
17706
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51530163
BCBS OF AL
AL
01
7878489
AETNA
AL
05
890016400
AL
Enumeration date
07/05/2006
Last updated
03/26/2017
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