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1083315477
PASQUINA REVANCHE
BROCKTON, MA
NPI
1083315477
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MA LN94663)
Enumeration Date
2023-03-13
Last Update Date
2023-03-13
Business Address
PASQUINA REVANCHE
315 BELAIR ST
BROCKTON, MA 02301-2029
Phone number: 617-849-0535
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Mailing Address
PASQUINA REVANCHE
315 BELAIR ST
BROCKTON, MA 02301-2029
Phone number: 617-849-0535
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