| NPI | 1225329501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICAH KRUGER Physician 860-728-6740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2021-03-12 |