MEDICARE: KERRI MCDONALD M.S.P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	15246	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	496844	OTHER	MA	TUFTS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	Y68737	OTHER	MA	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1194912303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI MCDONALD M.S.P.T.

Provider Business Mailing Address
First Line	:	322 E CENTER ST
Second Line	:
City	:	WEST BRIDGEWATER
State	:	MA
Zip	:	02379-1824
Country	:	US
Telephone Number	:	508-559-0993
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 E CENTER ST
Second Line	:
City	:	WEST BRIDGEWATER
State	:	MA
Zip	:	02379-1824
Country	:	US
Telephone Number	:	508-565-5070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	05/22/2008

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