| NPI | 1497709885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY P. JOLLY Owner 860-229-2807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CT 000090) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2010-01-13 |