Individual
FREDRICK MWATHI MUTITU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16 BENEFIT ST, APT. 1 L, WORCESTER, MA 01610-1551
(774) 253-3494
Mailing address
16 BENEFIT ST, APT. 1 L, WORCESTER, MA 01610-1551
(774) 253-3494
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN87206
MA
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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