| NPI | 1659021350 |
|---|---|
| Doing Business As | MILE SQUARE SOUTH SHORE |
| Entity Type | Organization |
| Authorized Contact | HENRY TAYLOR CEO 312-413-1832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2022-03-25 |