Healthcare Provider Details

I. General information

NPI: 1407885908
Provider Name (Legal Business Name): LISA MARA MEEHAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 WASHINGTON ST
ATTLEBORO MA
02703-7944
US

IV. Provider business mailing address

703 GRANITE ST STE 3
BRAINTREE MA
02184-5350
US

V. Phone/Fax

Practice location:
  • Phone: 781-961-3370
  • Fax:
Mailing address:
  • Phone: 781-961-3370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT02007
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: