Organization
BOSTON MANTRA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONJY A ANANTH MD MBA (PRINCIPAL)
(617) 543-6366
Entity
Organization
Contact information
Practice address
9A BROADWAY ST, LAWRENCE, MA 01840
(617) 543-6366
Mailing address
14 LAMPLIGHTER DRIVE, SHREWSBURY, MA 01545
(617) 543-6366
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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