Individual
SONNLY RIBOURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
195 CANAL ST, MALDEN, MA 02148-6701
(781) 338-0500
Mailing address
158 HANCOCK ST, APT 1, EVERETT, MA 02149-1333
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5114
MA
Other
Enumeration date
08/01/2014
Last updated
08/24/2015
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