Individual
MR. MICHAEL ANTHONY MANDELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA LIC 99
Contact information
Practice address
615 RESERVOIR RD, LUNENBURG, MA 01462-1540
(978) 771-7582
(978) 582-8264
Mailing address
615 RESERVOIR RD, LUNENBURG, MA 01462-1540
(978) 771-7582
(978) 582-8264
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA99
MA
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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