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1083019764
ELLEN PROEUNG
BOSTON, MA
NPI
1083019764
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MA PA5162)
Enumeration Date
2014-10-24
Last Update Date
2014-10-24
Business Address
-- ELLEN PROEUNG PA
75 FRANCIS ST
BOSTON, MA 02115-6110
Phone number: 617-632-3206
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Mailing Address
-- ELLEN PROEUNG PA
75 FRANCIS ST
BOSTON, MA 02115-6110
Phone number:
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