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1184691891
IVY LYNN BRACKUP
DORCHESTER, MA
NPI
1184691891
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MA 15530)
Enumeration Date
2006-03-01
Last Update Date
2024-09-11
Business Address
Dr. IVY LYNN BRACKUP MD
1353 DORCHESTER AVE
DORCHESTER, MA 02122-2932
Phone number: 617-288-3230
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Mailing Address
Dr. IVY LYNN BRACKUP MD
1353 DORCHESTER AVE
DORCHESTER, MA 02122-2932
Phone number: 617-288-3230
Copy
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