Individual
MR. JOHN C. BREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S. , P.T.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
5162
MA
225100000X
Physical Therapist
Primary
5162
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y65702
PROVIDER NUMBER
MA
Enumeration date
11/20/2006
Last updated
01/15/2019
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