MEDICARE: JOANNA S BRIODY PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	3052	MA

General Provider Information

NPI Number	:	1891771564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA S BRIODY PT

Provider Business Mailing Address
First Line	:	109 RHODE ISLAND RD
Second Line	:	SHRIVER
City	:	LAKEVILLE
State	:	MA
Zip	:	02347-1370
Country	:	US
Telephone Number	:	508-923-6032
Fax Number	:	508-923-6361

Provider Business Practice Location Address
First Line	:	109 RHODE ISLAND RD
Second Line	:	SHRIVER
City	:	LAKEVILLE
State	:	MA
Zip	:	02347-1370
Country	:	US
Telephone Number	:	508-923-6032
Fax Number	:	508-923-6361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	07/08/2007

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Directions to “ JOANNA S BRIODY PT” Practice Location

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