Provider Demographics
NPI:1245811892
Name:DELATORRE, ADILSON
Entity type:Individual
Prefix:
First Name:ADILSON
Middle Name:
Last Name:DELATORRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 OLYMPIC CT
Mailing Address - Street 2:
Mailing Address - City:EAST WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02032-1044
Mailing Address - Country:US
Mailing Address - Phone:617-688-6175
Mailing Address - Fax:
Practice Address - Street 1:27 OLYMPIC CT
Practice Address - Street 2:
Practice Address - City:EAST WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02032-1044
Practice Address - Country:US
Practice Address - Phone:617-688-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist