Provider Demographics
NPI:1265659643
Name:BRUNELL, PAULA JOYCE (PT)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:JOYCE
Last Name:BRUNELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 JUNE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-3249
Mailing Address - Country:US
Mailing Address - Phone:508-791-4257
Mailing Address - Fax:508-845-2783
Practice Address - Street 1:214 LAKE ST
Practice Address - Street 2:CHILD DEVELOPMENT BUILDING
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3960
Practice Address - Country:US
Practice Address - Phone:508-856-4202
Practice Address - Fax:508-845-2783
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist