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Individual

JOSHUA E. DEISENROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
123 SUMMER ST, WORCESTER, MA 01608-1200
(508) 363-7180
(508) 363-7164
Mailing address
123 SUMMER ST, WORCESTER, MA 01608-1200
(508) 363-7180
(508) 363-7164

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1088
MA

Other

Enumeration date
03/23/2006
Last updated
10/03/2022
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