Individual
EDDER GEOVANNY MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
360 MERRIMACK ST STE 9, LAWRENCE, MA 01843-1764
(978) 655-6652
(833) 963-2112
Mailing address
87 PHILLIPS ST, METHUEN, MA 01844-4311
(978) 835-5358
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN101085
MA
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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