Individual
KOAMI GENTIL MESSANTCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 KENMAR DR UNIT 164, BILLERICA, MA 01821-4793
(617) 763-8489
Mailing address
18 KENMAR DR UNIT 164, BILLERICA, MA 01821-4793
(617) 763-8489
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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