| NPI | 1346484672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENWORTH ELLIS Managing Member 860-243-1864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CT 041803) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |