| Doctor Name: | MACKENZIE O'DEA |
| NPI Number: | 1043619208 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 21294 |
| Business Practice Address: | 119 Washington St Norwell, MA - 020611728 |
| Business Phone Number: | 7818719500 |
| Business Fax Number: | 7818719525 |
| Mailing Address: | 210 Commerce Way, Suite 120 PORTSMOUTH |
| State: | NH |
| Postal Code: | 038018200 |
| Phone Number: | 6034278066 |
| Fax Number: | 6035010495 |
| NPI Enumeration Date: | 08/13/2014 |
| NPI Last Update Date: | 08/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 21294 |
| 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 |