Individual
KETTIE LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
850 HARRISON AVE, YACC 4, BOSTON, MA 02118-4001
(617) 414-2000
(617) 414-5798
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
177420
MA
Other
Enumeration date
03/24/2006
Last updated
06/30/2014
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