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General NPI Number Information
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NPI Number | 1992137756
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Entity Type | Organization
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Legal Business Name | KMQ PROFESSIONAL SERVICES LLC
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Dates
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Enumeration Date | 08/04/2013
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Last Update Date | 08/04/2013
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Provider Practice Location Address
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Address Line | 475 STERLING RD
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City | JEFFERSON
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State | MA
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Zip | 01522-1329
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Country | US
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Telephone | 508-335-4870
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Fax |
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Provider Business Mailing Address
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Address Line | 475 STERLING RD
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City | JEFFERSON
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State | MA
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Zip | 01522-1329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | KARA KITTREDGE-MILOTTE
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Credential |
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Telephone | 508-335-4870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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