Organization
SOUTHBORO MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER LABOSSIERE (CREDENTIALING SPECIALIST)
(508) 460-3297
Entity
Organization
Contact information
Practice address
24 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(508) 481-5500
(508) 460-3025
Mailing address
24 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(508) 481-5500
(508) 460-3025
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/30/2014
Last updated
05/30/2014
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