Individual
JOSE BIENVENIDO CORPORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
199 REEDSDALE RD, MILTON, MA 02186-3926
(617) 696-4600
Mailing address
15 LAFAYETTE ST, MILTON, MA 02186-2602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2091
MA
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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