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1013479708
AMANDA JEANNE DAVIDSON
GLOUCESTER, MA
NPI
1013479708
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QM2800X Clinic/Center, Methadone Clinic
Enumeration Date
2019-04-02
Last Update Date
2019-04-02
Business Address
AMANDA JEANNE DAVIDSON
23 DUNCAN ST
GLOUCESTER, MA 01930-6001
Phone number: 781-990-9090
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Mailing Address
AMANDA JEANNE DAVIDSON
23 DUNCAN ST
GLOUCESTER, MA 01930-6001
Phone number: 781-990-9090
Copy
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