Healthcare Provider Details

I. General information

NPI: 1225467996
Provider Name (Legal Business Name): SANDRA KERR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 N MAIN ST
NATICK MA
01760-1131
US

IV. Provider business mailing address

214 N MAIN ST
NATICK MA
01760-1131
US

V. Phone/Fax

Practice location:
  • Phone: 508-650-1856
  • Fax: 508-653-9563
Mailing address:
  • Phone: 508-650-1856
  • Fax: 508-653-9563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number8165
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: