| Doctor Name: | JESSICA SHATTUCK |
| NPI Number: | 1023308681 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 19301 |
| Business Practice Address: | 637 Washington Street Suite 102 Brookline, MA - 02446 |
| Business Phone Number: | 6177346135 |
| Business Fax Number: | 6177343744 |
| Mailing Address: | 29 Crafts Street, Suite 570 NEWTON |
| State: | MA |
| Postal Code: | 02458 |
| Phone Number: | 6179658010 |
| Fax Number: | 6179658071 |
| NPI Enumeration Date: | 04/15/2011 |
| NPI Last Update Date: | 11/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 19301 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |