Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 666 | MA |
NPI | 1629479688 |
---|---|
Provider Name | Eugene Ouellette JR. |
First Address | North Attleboro, MA 02760-1607 |
Second Address | North Attleboro, MA 02760-1607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2014 |
Last Update Date | 09/09/2014 |