NPI | 1245691203 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNY T VENTURA Owner 508-243-9331 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MA 7326) |
Enumeration Date | 2016-03-17 |
Last Update Date | 2016-06-07 |