Individual
MS. DOMENICA MARIA MOGAVERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
527 MAIN ST STE 14, MELROSE, MA 02176-3817
(781) 640-7893
Mailing address
240 PROCTOR AVE, REVERE, MA 02151-4923
(781) 640-7893
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
212401
MA
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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