| NPI | 1083667901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E LARSON Owner 617-536-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-12-03 |