Provider Demographics
NPI:1841507712
Name:MONTERIO, KATHLEEN NORA (DPT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:NORA
Last Name:MONTERIO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:NORA
Other - Last Name:MADGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:411 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3739
Mailing Address - Country:US
Mailing Address - Phone:978-263-0007
Mailing Address - Fax:078-263-0014
Practice Address - Street 1:411 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3739
Practice Address - Country:US
Practice Address - Phone:978-263-0007
Practice Address - Fax:078-263-0014
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist