Individual
KENNETH LUSWATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
84 KENDALL RD, JEFFERSON, MA 01522-1002
(857) 247-2474
Mailing address
84 KENDALL RD, JEFFERSON, MA 01522-1002
(857) 247-2474
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN953397
MA
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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