| NPI | 1336346063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MOSYCHUK Office Manager 508-539-3353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 210923) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MA 210923) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2008-04-08 |