Individual
MR. JONATHAN MOORE BARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
61 MEDFORD ST, SOMERVILLE, MA 02143-3421
(617) 629-3919
Mailing address
61 MEDFORD ST, SOMERVILLE, MA 02143-3421
(617) 629-3919
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/11/2009
Last updated
09/30/2010
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