| Pca In Pediatric Primary Care Llc | |
|
12 Alfred St Suite 200 Woburn MA 01801-1972 | |
| (781) 646-0500 | |
| (781) 646-7130 |
| Full Name | Pca In Pediatric Primary Care Llc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 12 Alfred St, Woburn, Massachusetts |
| Authorized Official Name and Position | Michael F Jacques (OWNER) |
| Authorized Official Contact | 7816460500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pca In Pediatric Primary Care Llc 12 Alfred St Suite 200 Woburn MA 01801-1972 Ph: (781) 646-0500 | Pca In Pediatric Primary Care Llc 12 Alfred St Suite 200 Woburn MA 01801-1972 Ph: (781) 646-0500 |
| NPI Number | 1013347103 |
|---|---|
| Provider Enumeration Date | 11/26/2013 |
| Last Update Date | 11/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013347103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
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