Individual
JESSE LAGERBLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 SCHOOL ST, LYNN, MA 01902-2952
(781) 715-2390
(781) 715-2423
Mailing address
20 SCHOOL ST, LYNN, MA 01902-2952
(781) 715-2390
(781) 715-2423
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN93551
MA
Other
Enumeration date
11/13/2019
Last updated
11/13/2019
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