Graduated: 2015
NPI: 1003299090
Practice Locations (2)
ID OF QUINCY LLC
40 INDUSTRIAL PARK RD, SUITE 202
PLYMOUTH, MA 023604884
6172022401
ID OF QUINCY LLC
104 QUARRY ST, SUITE 2
QUINCY, MA 021694174
6172022401
Source: CMS National Downloadable File, September 2026.