| NPI | 1396931648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN LEBLANC Owner 860-243-2951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: CT 000530) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2007-09-20 |