Individual
ELLEN RAYMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
92 WALLINGFORD RD APT 2, BRIGHTON, MA 02135-4706
(952) 693-5405
Mailing address
92 WALLINGFORD RD APT 2, BRIGHTON, MA 02135-4706
(952) 693-5405
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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