Carl Rudolph Blain

Individual provider Active NPI Health Service Clinic/Center · Holbrook, MA

NPI 1801472840 · NPPES record last updated Mar 21, 2021

Key facts

NPI
1801472840
Entity type
Individual (NPI type 1)
Primary specialty
Health Service Clinic/Center 261QH0100X
Practice address
28 Worcester PL
Holbrook, MA 02343-1085
Phone
(857) 308-6508
NPI assigned
Mar 21, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Yes

Addresses

Primary practice location

28 Worcester PL
Holbrook, MA 02343-1085

Mailing address

28 Worcester PL
Holbrook, MA 02343-1085
Phone (857) 308-6508

Other names

  • Carl Rudolph Blain Professional name

Other providers in Holbrook, MA

All providers in Holbrook, MA · Health Service Clinic/Center in Massachusetts

Sources for this page

Verify at the official NPI Registry.