Individual
JAMIE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
484 MAIN ST, WORCESTER, MA 01608-1893
(508) 751-6322
Mailing address
69 WARREN AVE UNIT 3, WOBURN, MA 01801-4948
(704) 942-7478
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8644
MA
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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