| 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 |