| NPI | 1376588004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA DETOMA SWANSON Practice Administrator 617-730-9814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MA 80434) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |