Individual
MRS. TINA I MELIFONWU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19 MILFORD RD, SOUTH GRAFTON, MA 01560-1245
(508) 400-0740
Mailing address
19 MILFORD RD, SOUTH GRAFTON, MA 01560-1245
(508) 400-0740
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN64624
MA
Other
Enumeration date
05/26/2009
Last updated
06/09/2009
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