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1164576229
MICHELLE VIDAL
BOSTON, MA
NPI
1164576229
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MA 236195)
Enumeration Date
2007-01-23
Last Update Date
2013-12-30
Business Address
-- MICHELLE VIDAL NP
15 PARKMAN ST WANG BUILDING ROOM 745
BOSTON, MA 02114-3117
Phone number: 617-726-3303
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Mailing Address
-- MICHELLE VIDAL NP
2 EASTLAND RD
JAMAICA PLAIN, MA 02130-4617
Phone number: 617-699-1738
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