Doctor Name: | AMANDA LYNN TETREAULT |
NPI Number: | 1255306668 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSPT |
License Number: | 17393 |
Business Practice Address: | 1101 Beacon St Ste 5e Brookline, MA - 024465587 |
Business Phone Number: | 6172326633 |
Business Fax Number: | 6172326832 |
Mailing Address: | 1780 Beacon St, #1 BROOKLINE |
State: | MA |
Postal Code: | 024452030 |
Phone Number: | 6179742980 |
Fax Number: | |
NPI Enumeration Date: | 02/20/2006 |
NPI Last Update Date: | 10/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 17393 |
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 |