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Organization

TIFFANY DOUGLAS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY DOUGLAS (FNP/ PRIMARY CARE PROVIDER)
(864) 423-3561
Entity
Organization

Contact information

Practice address
1 SOLDIERS FIELD PARK, APT 501, BOSTON, MA 02163-1722
(864) 423-3561
Mailing address
1 SOLDIERS FIELD PARK, APT 501, BOSTON, MA 02163-1722
(864) 423-3561

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
RN2299504
MA

Other

Enumeration date
09/29/2015
Last updated
09/29/2015
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