Individual
MR. LEAWOOD P EMMERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
123 SUMMER ST, WORCESTER, MA 01608-1216
(508) 368-3130
(508) 368-3167
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605
(508) 368-3130
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
60
MA
Other
Enumeration date
01/10/2006
Last updated
07/21/2022
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