Individual
JACK DEANUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
39 HOLDEN ST, ATTLEBORO, MA 02703-1717
(508) 431-9031
Mailing address
39 HOLDEN ST, ATTLEBORO, MA 02703-1717
(508) 431-9031
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN65979
MA
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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