Individual
COURTNEY SHEA BLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3550
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA101492
MA
Other
Enumeration date
07/23/2024
Last updated
03/05/2025
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