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NPI Code Detail

MEDICARE: BARBARA A CLANCY

MEDICARE: BARBARA A CLANCY
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
1222Z00000XOrthotistC52053

General Provider Information

NPI Number : 1477056158
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA A CLANCY
Provider Business Mailing Address
First Line : 6 GEORGE ST
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-1487
Country : US
Telephone Number : 774-269-8640
Fax Number :
Provider Business Practice Location Address
First Line : 199 REEDSDALE RD
Second Line :
City : MILTON
State : MA
Zip : 02186-3926
Country : US
Telephone Number : 617-698-6334
Fax Number : 617-698-6334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2018
Last Update Date : 06/16/2018

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Directions to “ BARBARA A CLANCY ” Practice Location

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