Individual
MR. STANLEY W. MODRZAKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040
(413) 582-3178
Mailing address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040
(413) 582-3178
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
136653
MA
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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