NPI | 1497052930 |
---|---|
Entity Type | Organization |
Authorized Contact | DENNIS ANTHONY BRADLEY Clinical Director 978-342-2709 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA 0007433) |
Enumeration Date | 2011-02-18 |
Last Update Date | 2011-02-18 |