Provider Demographics
NPI:1609058031
Name:SIET, WENDY BORODKIN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:BORODKIN
Last Name:SIET
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 INDEPENDENCE LN
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-3025
Mailing Address - Country:US
Mailing Address - Phone:508-881-8124
Mailing Address - Fax:
Practice Address - Street 1:115 INDEPENDENCE LN
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-3025
Practice Address - Country:US
Practice Address - Phone:508-881-8124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist