Individual
BRANDON DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
45 DIMOCK ST FL 3, ROXBURY, MA 02119-1208
(617) 445-0647
(617) 427-0403
Mailing address
1 CREDIT UNION WAY FL 3, RANDOLPH, MA 02368-4633
(781) 961-3337
(781) 961-1291
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24027
MA
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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