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Organization
DVAWORLDRX, LLC
Active
Organization
DVAWORLDRX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN CELES MANZANILLO (MANAGER)
(781) 241-2782
Entity
Organization
Contact information
Practice address
274 KENNEBEC ST, HYDE PARK, MA 02136-6206
(781) 241-2782
(857) 703-2625
Mailing address
274 KENNEBEC ST, HYDE PARK, MA 02136-6206
(781) 241-2782
(857) 703-2625
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NULL
Other
Enumeration date
06/01/2021
Last updated
06/01/2021
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