NPI | 1235281288 |
---|---|
Entity Type | Organization |
Authorized Contact | LYNN M LEBLANC Podiatirst 860-243-1951 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 000530) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2021-06-17 |