Individual
MR. KEVIN ANTONY MANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
136 HARRISON AVE, BOSTON, MA 02111-1817
(781) 990-9953
Mailing address
15 JOHNSON RD, WEYMOUTH, MA 02191-1109
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E0918754
MA
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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