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NPI Code Detail

MEDICARE: MRS. CRISTEN AILEEN BUSSIERE PT

MEDICARE:  MRS. CRISTEN AILEEN BUSSIERE  PT
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
1225100000XPhysical Therapist8278MA

General Provider Information

NPI Number : 1790119006
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CRISTEN AILEEN BUSSIERE PT
Provider Business Mailing Address
First Line : 32 MAYO DR
Second Line :
City : HOLDEN
State : MA
Zip : 01520-1512
Country : US
Telephone Number : 508-829-1196
Fax Number : 508-829-1235
Provider Business Practice Location Address
First Line : 32 MAYO DR
Second Line :
City : HOLDEN
State : MA
Zip : 01520-1512
Country : US
Telephone Number : 508-829-1196
Fax Number : 508-829-1235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2013
Last Update Date : 08/23/2013

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Directions to “ MRS. CRISTEN AILEEN BUSSIERE PT” Practice Location

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