Individual
KACIE J KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 559-0473
Mailing address
1115 W CHESTNUT ST, BROCKTON, MA 02301-7501
(508) 559-0473
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2266429
MA
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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