Organization
EXCALIBER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SHOVER (OWNER)
(413) 209-2515
Entity
Organization
Contact information
Practice address
9 MILNER ST, WARE, MA 01082-1527
(413) 209-2515
Mailing address
9 MILNER ST, WARE, MA 01082-1527
(413) 209-2515
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
S99657387
MA
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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