Individual
MR. JOEL K WANGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
19 MADRID SQ, SUITE 12, BROCKTON, MA 02301-1247
(617) 650-8669
Mailing address
19 MADRID SQ, SUITE 12, BROCKTON, MA 02301-1247
(617) 650-8669
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN62785
MA
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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