Individual
MISS JOAN ELIZABETH PADRENOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
165 COURT ST, BROCKTON, MA 02302-4608
(508) 897-0007
(508) 897-0020
Mailing address
144 PINEHURST AVE, SWANSEA, MA 02777-2317
(508) 678-0283
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4211
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4211
PHYSICAL THERAPY ASSISTANT
MA
Enumeration date
04/06/2018
Last updated
04/06/2018
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