Organization
GROTON MEDICAL WELLNESS SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEAN M NORDIN-EVANS DDS (OWNER)
(978) 449-9919
Entity
Organization
Contact information
Practice address
493 MAIN STREET, GROTON, MA 01450
(978) 449-9919
Mailing address
493 MAIN ST, GROTON, MA 01450-4254
(978) 449-9919
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
208D00000X
General Practice Physician
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
07/08/2008
Last updated
10/16/2009
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