| NPI | 1275052755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SABOURIN Owner 508-258-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: RI DPM00316) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: MA 2210) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2022-07-21 |