Individual
SANDRA FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
565 PEARL ST, BROCKTON, MA 02301-4500
(781) 291-2193
Mailing address
565 PEARL ST, BROCKTON, MA 02301-4500
(781) 291-2193
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN91461
MA
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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