Individual
MARK GERARD LATTIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 MAZZEO DR STE 204, RANDOLPH, MA 02368-3433
(508) 904-3491
Mailing address
10 MAZZEO DR STE 204, RANDOLPH, MA 02368-3433
(508) 904-3491
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11298
MA
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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