Organization
PREVENTIVE MEDICINE ASSOCIATES
Active
Parent organization
PREVENTIVE MEDICINE ASSOCIATES
Other names
West Roxbury Wellness Pavillion
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREVENTIVE MEDICINE ASSOCIATES
Authorized official
MS. MARY J DELONG MM,RHIA (CREDENTIALING MANAGER)
(413) 222-7711
Entity
Organization
Contact information
Practice address
1208B VFW PKWY, SUITE 305, WEST ROXBURY, MA 02132-4349
(617) 477-8294
(617) 477-8294
Mailing address
1208B VFW PKWY, SUITE 305, WEST ROXBURY, MA 02132-4349
(617) 477-8294
(617) 477-8294
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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