| NPI | 1508578535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC IMMERMAN VP Of Channel Partnerships 781-987-4896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2022-12-21 |