| NPI | 1386922151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER R DECKER Owner/Podiatrist 860-657-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 000853) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-07-28 |