| NPI | 1215235502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY AMIRTO Office Manager 508-655-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA 216066) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2012-02-20 |