Provider Demographics
NPI:1609054550
Name:WESLEY, JANICE MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MARIE
Last Name:WESLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JANICE
Other - Middle Name:MARIE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:25 GRANT STREET
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453
Mailing Address - Country:US
Mailing Address - Phone:781-647-9950
Mailing Address - Fax:781-899-9794
Practice Address - Street 1:25 GRANT STREET
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453
Practice Address - Country:US
Practice Address - Phone:781-647-9950
Practice Address - Fax:781-899-9794
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-02
Last Update Date:2008-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist