| NPI | 1063793826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE ALANNA WASHBURN Nurse Practitioner 508-496-5704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MA RN261281) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2011-09-07 |