| NPI | 1154492700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE S. THIBERT Medical Director 508-583-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2022-03-03 |