Individual
MRS. JUANITA DIANNE BELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
830 HARRISON AVE FL, MOAKLEY STE 3500, BOSTON, MA 02118
(617) 638-6525
Mailing address
801 ALBANY ST FL G, BOSTON, MA 02119-3791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA4126
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110122852A
—
MA
Enumeration date
02/17/2011
Last updated
04/06/2021
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