Individual
ODALID VILLALOBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593
Mailing address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
197537
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301071
—
MA
Enumeration date
05/21/2007
Last updated
07/09/2007
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