Individual
MATTHEW JOSEPH LAVALLEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 FRUIT ST, WHITE 1, BOSTON, MA 02114-2696
(617) 724-4100
(617) 726-7415
Mailing address
12 BALDWIN RD, WESTFORD, MA 01886-2066
(978) 799-1281
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA100060
MA
Other
Enumeration date
04/03/2023
Last updated
09/28/2023
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