Individual
WALLACE K MASSAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
190 DUDLEY ST, ROXBURY, MA 02119-2573
(617) 442-8600
Mailing address
190 DUDLEY ST, ROXBURY, MA 02119-2573
(617) 442-8600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3444
MA
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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