| NPI | 1225535867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE MCCULLOUGH President 978-549-6818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IN 0700115A) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |