Individual
MR. JASON BETTENCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
15 CHESTNUT ST, PEABODY, MA 01960-5429
(978) 998-9993
Mailing address
6 MOULTON AVE, SALEM, MA 01970-2524
(978) 998-9993
Taxonomy
Speciality
Code
Description
License number
State
175L00000X
Homeopath
Primary
7006
MA
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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