Provider Demographics
NPI:1659066009
Name:VIGEVANI, KERRY HELEN (PT)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:HELEN
Last Name:VIGEVANI
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 1:100 ONEIL BLVD
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-4218
Mailing Address - Country:US
Mailing Address - Phone:508-342-1104
Mailing Address - Fax:508-342-1947
Practice Address - Street 1:100 ONEIL BLVD
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-4218
Practice Address - Country:US
Practice Address - Phone:508-342-1104
Practice Address - Fax:508-342-1947
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist