Individual
MS. CAROL MARIE MCTAVISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
36 MEYER ST, ROSLINDALE, MA 02131-2231
(617) 325-7450
Mailing address
36 MEYER ST, ROSLINDALE, MA 02131-2231
(617) 325-7450
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
54155
MA
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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