Individual
ANSEL GARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 COLLEGE ST, WORCESTER, MA 01610-2322
(508) 793-2627
(508) 793-3974
Mailing address
15 WIESER DR, WESTFIELD, MA 01085-5130
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2235
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000006552
BOARD OF CERTIFICATION
MA
Enumeration date
10/05/2011
Last updated
10/05/2011
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