Individual
SAMANTHA JAYNE WALAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 JEROME ST, MEDFORD, MA 02155-3534
(413) 218-1043
Mailing address
16 SANBORN AVE, WEST ROXBURY, MA 02132-3818
(617) 218-1043
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN2309155
MA
Other
Enumeration date
03/14/2019
Last updated
03/14/2019
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