Individual
MARIE C MASSILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 575-5850
Mailing address
160 GORE STREET, CAMBRIDGE, MA 02139
(617) 575-5850
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN97158
MA
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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