Individual
JOHN WAITHERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
119 GROVE ST APT 218, ROCKLAND, MA 02370-2351
(339) 788-6934
Mailing address
119 GROVE ST APT 218, ROCKLAND, MA 02370-2351
(339) 788-6934
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN86033
MA
Other
Enumeration date
02/14/2015
Last updated
02/14/2015
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