| NPI | 1265730162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATHALLA MASHALI President 617-548-5959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MA 152670) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: MA 152670) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2011-03-02 |