Healthcare Provider Details

I. General information

NPI: 1982518387
Provider Name (Legal Business Name): JAMIE FOSSA P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 GREAT RD STE 306
ACTON MA
01720-4766
US

IV. Provider business mailing address

289 GREAT RD STE 306
ACTON MA
01720-4766
US

V. Phone/Fax

Practice location:
  • Phone: 617-953-8008
  • Fax:
Mailing address:
  • Phone: 617-953-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL27878
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: