Healthcare Provider Details

I. General information

NPI: 1346634102
Provider Name (Legal Business Name): MR. JOSEPH FRANCIS OWAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MEADOWBROOK RD
BROCKTON MA
02301-7122
US

IV. Provider business mailing address

10 MEADOWBROOK RD
BROCKTON MA
02301-7122
US

V. Phone/Fax

Practice location:
  • Phone: 508-742-4420
  • Fax: 508-742-4430
Mailing address:
  • Phone: 508-742-4420
  • Fax: 508-742-4430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: