| NPI | 1164816971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONAN ROBERT PARKE Owner 781-330-2791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NV 2004) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2020-06-22 |