Individual
JEROME MACKESY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
402A BLUE HILL AVE, DORCHESTER, MA 02121-4315
(617) 645-3766
Mailing address
PO BOX 500, LONDONDERRY, NH 03053-0500
(617) 645-3766
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8665
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0716669
—
MA
Enumeration date
11/25/2008
Last updated
09/22/2022
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