| NPI | 1366601106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILLARD T. HENNESSEE President 617-268-1745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA 1614) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: MA 001614) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2010-04-27 |