Individual
MRS. SANDRA GRAHAM PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDM RD
Contact information
Practice address
481 GREAT ROAD, SUITE 10, ACTON, MA 01720
(978) 266-1576
Mailing address
481 GREAT ROAD, SUITE 10, ACTON, MA 01720
(978) 266-1576
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
60
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39477
HARVARD PILGRIM
MA
01
—
467468
TUFTS
MA
01
—
LD0016
BLUE CROSS BLUE SHIELD
MA
Enumeration date
09/07/2006
Last updated
11/08/2012
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