| NPI | 1639562903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN T HADEN Owner 617-731-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: MA 79778) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-09-09 |