Individual
ESOHE MARIAN IDEHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 CAMBO ST, 4 CAMBO STREET, BROCKTON, MA 02301-5863
(857) 247-3739
Mailing address
4 CAMBO ST, 4 CAMBO STREET, BROCKTON, MA 02301-5863
(857) 247-3739
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
98489
MA
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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