| NPI | 1144986803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIANNE GRACE Owner 508-292-6730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2023-11-30 |