Individual
KEVIN WILLIAM ROUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
69 PLEASANT ST, MILLIS, MA 02054-1477
(774) 249-8782
Mailing address
69 PLEASANT ST, MILLIS, MA 02054-1477
(774) 249-8782
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
146044
MA
Other
Enumeration date
01/10/2021
Last updated
01/10/2021
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