Provider Demographics
NPI:1447783907
Name:O'TOOLE, MEGHAN
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:O'TOOLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 JOHN MAHAR HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-6563
Mailing Address - Country:US
Mailing Address - Phone:781-214-1717
Mailing Address - Fax:339-201-3374
Practice Address - Street 1:501 JOHN MAHAR HWY STE 100
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-6563
Practice Address - Country:US
Practice Address - Phone:781-214-1717
Practice Address - Fax:339-201-3374
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist