Individual
SEAN FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 WESTERN AVE, GLOUCESTER, MA 01930-3645
(978) 381-5636
Mailing address
10 WESTERN AVE, GLOUCESTER, MA 01930-3645
(978) 381-5636
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12492
MA
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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