Organization
DR. MILLARD T. HENNESSEE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILLARD T. HENNESSEE (PRESIDENT)
(617) 268-1745
Entity
Organization
Contact information
Practice address
654 E BROADWAY, SOUTH BOSTON, MA 02127-1502
(617) 268-1745
(617) 268-1748
Mailing address
654 E BROADWAY, SOUTH BOSTON, MA 02127-1502
(617) 268-1745
(617) 268-1748
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
001614
MA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1614
MA
Other
Enumeration date
06/06/2008
Last updated
04/27/2010
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