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Individual

CASEY WORNUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
12 BREWSTER RD, RANDOLPH, MA 02368-3804
(617) 633-6464
Mailing address
12 BREWSTER RD, RANDOLPH, MA 02368-3804
(617) 633-6464

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN87363
MA

Other

Enumeration date
09/05/2014
Last updated
09/05/2014
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