Individual
JESSICA L COLBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
725 ALBANY ST, SHAPIRO 8, SUITE A, BOSTON, MA 02118
(617) 638-8419
(617) 414-0201
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02111-2371
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002385
CT
363A00000X
Physician Assistant
Primary
PA5138
MA
Other
Enumeration date
03/12/2010
Last updated
03/13/2015
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