Basic Information
| Provider Information | |||||||||
| NPI: | 1013541796 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REAM | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | |||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | RANDOLPH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023684821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819619200 | ||||||||
| FaxNumber: | 7819616599 | ||||||||
| Practice Location | |||||||||
| Address1: | 26 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | RANDOLPH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023684821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819619200 | ||||||||
| FaxNumber: | 7819616599 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2020 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | PT295312 | CA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 225100000X | 24557 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.