Individual
PHYLLIS MACKAMUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12A MOUNT VERNON ST, WORCESTER, MA 01605-3465
(239) 308-8831
Mailing address
12A MOUNT VERNON ST, WORCESTER, MA 01605-3465
(239) 308-8831
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN99200
MA
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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