| NPI | 1043562812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE LUCILLE JEZEWSKI Owner 508-584-3278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: MA RN173824) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health (Licence: MA RN173824) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2015-10-01 |