Individual
MRS. MARTHA G CHARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
SOUTHBRIDGE PAIN CLINIC, 48 MAIN STREET SUITE 6, STURBRIDGE, MA 01566
(508) 347-9111
Mailing address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN01800
RI
363LF0000X
Family Nurse Practitioner
Primary
RN213217
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110197544A
—
MA
Enumeration date
06/01/2018
Last updated
12/28/2023
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