Individual
MARVIN EZHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
81 SKYLINE DR APT 7, BRAINTREE, MA 02184-1149
(857) 417-1390
Mailing address
81 SKYLINE DR APT 7, BRAINTREE, MA 02184-1149
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
MA
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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