Provider Demographics
NPI:1528171188
Name:P-TRULL, JANICE MICHELLE (DO)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:MICHELLE
Last Name:P-TRULL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:MICHELLE
Other - Last Name:PATASCIL-TRULL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:230 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTH ATTLEVORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-5518
Mailing Address - Country:US
Mailing Address - Phone:508-761-5650
Mailing Address - Fax:508-761-9870
Practice Address - Street 1:230 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:SOUTH ATTLEVORO
Practice Address - State:MA
Practice Address - Zip Code:02703-5518
Practice Address - Country:US
Practice Address - Phone:508-761-5650
Practice Address - Fax:508-761-9870
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA236883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine