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General NPI Number Information
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NPI Number | 1235330101
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Entity Type | Individual
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Provider Name | KATHLEEN F GUNNERY PT
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 170 GOVERNORS AVE
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City | MEDFORD
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State | MA
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Zip | 02155-1643
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Country | US
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Telephone | 781-306-6950
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Fax |
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Provider Business Mailing Address
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Address Line | 24 BURBANK RD
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City | LONDONDERRY
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State | NH
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Zip | 03053-3170
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Country | US
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Telephone | 603-434-3027
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3409
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License Number State | MA
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