Provider Demographics
NPI:1013499987
Name:LONGWE, MARGARET ANN (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:LONGWE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ANN
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:585 SUMNER ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3468
Mailing Address - Country:US
Mailing Address - Phone:781-413-1378
Mailing Address - Fax:
Practice Address - Street 1:215 THATCHER ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3949
Practice Address - Country:US
Practice Address - Phone:508-583-5834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3569OtherPROFESSIONAL LICENSURE