| NPI | 1407618648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER SUSSMAN Owner 781-591-7855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2024-01-24 |