Individual
LUIS M MENDONCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 BROADWAY, REVERE, MA 02151-5016
(503) 449-9745
Mailing address
171 BRISTOL AVE, PAWTUCKET, RI 02861-2240
(503) 449-9745
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3086
MA
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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