| NPI | 1073928552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM L THORNSON Owner/Partner 774-992-7058 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| 111N00000X Chiropractor | |
| 122300000X Dentist | |
| 124Q00000X Dental Hygienist | |
| 152W00000X Optometrist | |
| 163W00000X Registered Nurse | |
| 164W00000X Licensed Practical Nurse | |
| 247100000X Radiologic Technologist | |
| 2471V0105X Radiologic Technologist, Vascular Sonography | |
| 2472E0500X Technician, Other, EEG | |
| 363A00000X Physician Assistant | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 225100000X Physical Therapist (Licence: MA PA768) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2015-01-23 |