Individual
DOMINIC ANTHONY MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
214 WESTERLY CIR, LUDLOW, MA 01056-1622
(413) 310-6991
Mailing address
214 WESTERLY CIR, LUDLOW, MA 01056-1622
(413) 310-6991
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1234567890
MA
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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