| NPI | 1174763619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN GILLIS Manager 781-444-9080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MA 41758) |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2009-07-14 |