Basic Information
| Provider Information | |||||||||
| NPI: | 1982887824 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALON | ||||||||
| FirstName: | HEATHER | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 PARKMAN ST | ||||||||
| Address2: | WACC 134 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021143117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177240125 | ||||||||
| FaxNumber: | 6177262957 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 PARKMAN ST | ||||||||
| Address2: | WACC 134 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021143117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177240125 | ||||||||
| FaxNumber: | 6177262957 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2007 | ||||||||
| LastUpdateDate: | 12/14/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251N0400X | 13255 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology |
No ID Information.