Jonathan Allen Bly, PTA

NPI #1609232636 in Roslindale, Massachusetts

Provider Information

NPI Number: 1609232636
Entity Type: Individual
Name: Jonathan Allen Bly, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: PTA
Enumeration Date: Jan 6, 2016
Last Updated: Jan 6, 2016

Practice Location

Address: 15 MOSGROVE AVE
City: Roslindale
State: Massachusetts
ZIP Code: 02131-1113
Phone: (617) 401-5892

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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Organizations

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