| NPI | 1376644872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGIA KIM WEEBER President 413-584-2171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MA 2163) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: MA 2163) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA 2163) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-01-03 |