Individual
MARK PAUL MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HIS
Contact information
Practice address
115 MAIN ST, NORTH ADAMS, MA 01247-3409
(413) 662-2151
(413) 664-3283
Mailing address
115 MAIN ST, NORTH ADAMS, MA 01247-3409
(413) 662-2151
(413) 664-3283
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
119
MA
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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