Individual
KOURTNEY KACIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(617) 629-6000
Mailing address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(617) 629-6000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MA
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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