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Individual

CARLA JV BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
524 BOSTON POST RD, WAYLAND, MA 01778-1833
(508) 358-4900
(508) 358-3525
Mailing address
524 BOSTON POST RD, WAYLAND, MA 01778-1833
(508) 358-4900
(508) 358-3525

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17888
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000087601
MEDICARE PTAN
MA
01
17888
STATE LICENCE
MA
Enumeration date
05/04/2007
Last updated
08/30/2011
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