Individual
THERESA THACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4 MORGAN ST, RANDOLPH, MA 02368-2216
(857) 334-6533
Mailing address
4 MORGAN ST, RANDOLPH, MA 02368-2216
(857) 334-6533
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2268940
MA
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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