| NPI | 1326282518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFAEL GONZALEZ Owner 860-263-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CT 000808) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: CT 000808) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 000808) | |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2015-11-06 |