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Doctors / MA
PHYSICAL THERAPIST IN PRIVATE PRACTICE
Graduated: 2001
NPI: 1053268128
52 RAVENWOOD LN
WEST SPRINGFIELD, MA 010894577
PO BOX, 821322 ATTN POWERBACK CREDENTIALING DEPT
Philadelphia, PA 191821322
Source: CMS National Downloadable File, September 2026.