NPI 1629741509

Mark Gerard Lattimore

Practitioner Massage Therapist Randolph, MA

Practice location

Address: 10 Mazzeo Dr STE 204, Randolph, MA 02368-3433
Phone: (508) 904-3491

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 11298 (MA)

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Registry record

NPI: 1629741509
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jul 2021
Record last updated: 27 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.