| NPI | 1053440321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCY ANN DILIDDO Compliance Officer 781-290-1807 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: ME 335E00000X) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ME 332B00000X) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2022-10-24 |