NPI | 1588947428 |
---|---|
Entity Type | Organization |
Authorized Contact | SANG JIN LEE Owner 508-743-7888 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA 21084) |
Enumeration Date | 2011-09-27 |
Last Update Date | 2011-10-07 |