| NPI | 1144656364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L NILES Owner 617-726-4132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MA 54243) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2015-02-04 |