Individual
SHIRLEY CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26 PIEDMONT AVE, WALTHAM, MA 02451-3013
(781) 325-5177
Mailing address
26 PIEDMONT AVE, WALTHAM, MA 02451-3013
(781) 325-5177
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
724722
NY
Other
Enumeration date
03/17/2017
Last updated
03/17/2017
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