Individual
MICHELLE LEE DUTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, DS PCAS
Contact information
Practice address
68 ALLISON AVE, TAUNTON, MA 02780-6958
(508) 880-0202
Mailing address
143 ROCKY MEADOW ST, MIDDLEBORO, MA 02346-3011
(508) 245-5146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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