Individual
MR. ELIEZEL ELOI DIAZ I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 W. CHESTNUT ST, BROCKTON, MA 02301
(508) 580-4691
Mailing address
98 HANCOCK AVE, BROCKTON, MA 02301-2941
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/17/2013
Last updated
12/17/2013
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