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 |