Individual
DONNA MARIE KENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
55 SAYLES ST, SOUTHBRIDGE, MA 01550-1729
(508) 764-2400
(508) 909-7770
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 764-2432
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5624
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110118960A
—
MA
Enumeration date
01/22/2007
Last updated
11/21/2024
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