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NPI Code Detail

MEDICARE: MRS. VIDA MARIA JUODAITIS

MEDICARE: MRS. VIDA MARIA JUODAITIS
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
12251G0304XGeriatric Physical Therapist8795MA

General Provider Information

NPI Number : 1447473087
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VIDA MARIA JUODAITIS
Provider Business Mailing Address
First Line : 72 EASTER BROOK RD
Second Line :
City : LUNENBURG
State : MA
Zip : 01462-1677
Country : US
Telephone Number : 978-582-4982
Fax Number : 978-582-5592
Provider Business Practice Location Address
First Line : 56 BOYDEN RD
Second Line :
City : HOLDEN
State : MA
Zip : 01520-2570
Country : US
Telephone Number : 508-829-1210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. VIDA MARIA JUODAITIS ” Practice Location

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