Individual
MS. HOLLY SEVERANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7299
(508) 941-6299
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5648
MA
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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