Individual
DARRELL ANDREW BETHURUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 LITTLE HARBOR RD, WOODS HOLE, MA 02543
(508) 457-3229
(508) 457-3424
Mailing address
1 LITTLE HARBOR RD, WOODS HOLE, MA 02543
(508) 457-3229
(508) 457-3424
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24720000X
TECHNICIAN
MA
Enumeration date
04/18/2007
Last updated
07/08/2007
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