| NPI | 1629302112 |
|---|---|
| Doing Business As | WEST ROXBURY WELLNESS PAVILLION |
| Entity Type | Organization |
| Authorized Contact | MARY J DELONG Credentialing Manager 413-222-7711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2009-09-30 |