Organization
EVERGREEN VALLEY MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL FAGIEN MD (OWNER)
(508) 930-7659
Entity
Organization
Contact information
Practice address
170 TILTING ROCK RD, WRENTHAM, MA 02093-1358
(508) 930-7659
Mailing address
PO BOX 511, WRENTHAM, MA 02093-0511
(508) 930-7659
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
02/15/2007
Last updated
08/22/2020
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