Provider Demographics
NPI:1245783901
Name:BABB-WETHERELL, MARISA RAE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:RAE
Last Name:BABB-WETHERELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:RAE
Other - Last Name:BABB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:200 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-1872
Mailing Address - Country:US
Mailing Address - Phone:413-695-5683
Mailing Address - Fax:
Practice Address - Street 1:25 MESSENGER ST STE 7
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-5012
Practice Address - Country:US
Practice Address - Phone:774-307-0074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist