MR. Michael Anthony Mandella, MA LIC 99

NPI #1285272559 in Lunenburg, Massachusetts

Provider Information

NPI Number: 1285272559
Entity Type: Individual
Name: MR. Michael Anthony Mandella, MA LIC 99
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: MA LIC 99
Enumeration Date: Dec 17, 2019
Last Updated: Dec 17, 2019

Practice Location

Address: 615 RESERVOIR RD
City: Lunenburg
State: Massachusetts
ZIP Code: 01462-1540
Phone: (978) 771-7582

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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