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General NPI Number Information
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NPI Number | 1144053620
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Entity Type | Individual
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Provider Name | JESSICA FAULKNER PT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 73 PRINCETON ST # 8
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City | NORTH CHELMSFORD
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State | MA
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Zip | 01863-1558
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Country | US
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Telephone | 978-710-7204
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Fax |
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Provider Business Mailing Address
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Address Line | 22 PEARL ST
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City | NATICK
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State | MA
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Zip | 01760-4814
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Country | US
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Telephone | 508-661-9024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 27760
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License Number State | MA
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