Individual
MISS LORI ALICE GREEN-TUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 559-0473
Mailing address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 559-0473
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2259068
MA
Other
Enumeration date
03/13/2009
Last updated
10/07/2009
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