Individual
GEORGE GANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 LIBERTY ST, BROCKTON, MA 02301-5674
(508) 565-3275
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 894-0400
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
263157
MA
2085R0202X
Diagnostic Radiology Physician
MD445498
PA
Other
Enumeration date
07/25/2007
Last updated
06/10/2024
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