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General NPI Number Information
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NPI Number | 1659698454
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Entity Type | Organization
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Legal Business Name | DAVID OUELLETTE OF WAKEFIELD MA
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 05/03/2010
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Provider Practice Location Address
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Address Line | 599 NORTH AVE DOOR #9
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City | WAKEFIELD
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State | MA
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Zip | 01880-1648
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Country | US
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Telephone | 781-246-8706
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Fax | 339-219-6453
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Provider Business Mailing Address
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Address Line | 599 NORTH AVE DOOR #9
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City | WAKEFIELD
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State | MA
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Zip | 01880-1648
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Country | US
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Telephone | 781-246-8706
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Fax | 339-219-6453
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID J OUELLETTE
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Credential |
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Telephone | 781-246-8706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 8049
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License Number State | MA
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