| NPI | 1114100989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T CARROLL President 860-510-0502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2016-01-29 |