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Organization

MEDSOURCE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAY JOSEPH GAGNE EET (PARTNER)
(757) 220-5051
Entity
Organization

Contact information

Practice address
3909 MIDLANDS ROAD,, SUITE: B, WILLIAMSBURG, VA 23188
(757) 220-5051
(757) 220-5053
Mailing address
3909 MIDLANDS ROAD,, SUITE: B, WILLIAMSBURG, VA 23188
(757) 220-5051
(757) 220-5053

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101051020
VA

Other

Enumeration date
08/21/2009
Last updated
08/21/2009
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