Individual
MR. EARNEST GILDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
5 PARK VALE, APT 4C, BROOKLINE, MA 02446-6228
(617) 596-3429
Mailing address
5 PARK VALE, APT 4C, BROOKLINE, MA 02446-6228
(617) 596-3429
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-10217-MT
MA
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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