| NPI | 1568596732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN M MANDEVILLE Team Leader 508-238-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0200X Chiropractor, Radiology (Licence: MA ch2416) |
| Additional Taxonomies | 111NR0200X Chiropractor, Radiology (Licence: MS CE004979) |
| 247100000X Radiologic Technologist | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |