Provider Demographics
NPI:1447586045
Name:VINTRO, PAULA JEANNE (PTA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:JEANNE
Last Name:VINTRO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OSTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02655
Mailing Address - Country:US
Mailing Address - Phone:508-428-0300
Mailing Address - Fax:508-428-1211
Practice Address - Street 1:719 MAIN ST
Practice Address - Street 2:
Practice Address - City:OSTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02655
Practice Address - Country:US
Practice Address - Phone:508-428-0300
Practice Address - Fax:508-428-1211
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA#2433225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant