| NPI | 1609653815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY KO Np 978-206-1860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2025-05-07 |