Individual
MRS. AMY ELLEN SANBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED CEIS CIMI
Contact information
Practice address
1115 WEST CHESTNUT ST, BROCKTON, MA 02301
(508) 559-0473
(508) 427-5361
Mailing address
78 CYPRESS ST, PLYMOUTH, MA 02360
(508) 759-4648
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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