Individual
MR. SCHADRAC EXANTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(508) 583-4500
Mailing address
20 ROCHE BROTHERS WAY UNIT 6-328, NORTH EASTON, MA 02356-1030
(508) 649-0569
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN97212
MA
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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