Organization
FUNTIONAL MEDICINE GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ADDISON (PRESIDENT)
(781) 641-1901
Entity
Organization
Contact information
Practice address
88 SANDWICH ST, PLYMOUTH, MA 02360-3334
(781) 641-1901
Mailing address
88 SANDWICH ST, PLYMOUTH, MA 02360-3334
(781) 641-1901
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
215277
MA
Other
Enumeration date
10/15/2007
Last updated
10/15/2007
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