| NPI | 1629615828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER AUGUSTE BEDET Billing Manager 508-665-4344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2019-12-06 |