| NPI | 1174100366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANELLE MARIE SAE-EAW Office Manager 508-316-0725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2021-03-25 |