Evergreen Valley Medical, PC

NPI #1225171630 in Wrentham, Massachusetts

Provider Information

NPI Number: 1225171630
Entity Type: Organization
Organization Name: Evergreen Valley Medical, PC
Primary Specialty: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Enumeration Date: Feb 15, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 170 TILTING ROCK RD
City: Wrentham
State: Massachusetts
ZIP Code: 02093-1358
Phone: (508) 930-7659

Authorized Official

Name: DR. MICHAEL FAGIEN, MD
Title: OWNER
Phone: (508) 930-7659

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	335V00000X	Primary

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