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1881711331
RENEE L GANNON
BROOKLINE, MA
NPI
1881711331
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
314000000X Skilled Nursing Facility
(Licence: MA 1741)
Enumeration Date
2007-03-22
Last Update Date
2007-07-08
Business Address
MRS. RENEE L GANNON COTA L
30 WEBSTER ST
BROOKLINE, MA 02446-4938
Phone number: 617-734-2300
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Mailing Address
MRS. RENEE L GANNON COTA L
96 ELENE ST
LOWELL, MA 01854-1004
Phone number: 978-459-7666
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