Provider Demographics
NPI:1013541796
Name:REAM, LINDA (DPT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:REAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4821
Mailing Address - Country:US
Mailing Address - Phone:781-961-9200
Mailing Address - Fax:781-961-6599
Practice Address - Street 1:26 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4821
Practice Address - Country:US
Practice Address - Phone:781-961-9200
Practice Address - Fax:781-961-6599
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT295312208100000X
MA24557225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation