Organization
INDIVIDUAL
Active
Organization
INDIVIDUAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY ARCHAMBAULT (INTERN)
(401) 744-7167
Entity
Organization
Contact information
Practice address
81 PLANTATION STREET, WORCESTER, MA 01604
(185) 596-8461
Mailing address
81 PLANTATION SHEET, WORCESTER, MA 01604
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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