| NPI | 1669049995 |
|---|---|
| Former Legal Business Name | KD MEDICINE & WELLNESS |
| Doing Business As | KD MEDICINE & WELLNESS |
| Entity Type | Organization |
| Authorized Contact | KENNETH R DOVIDIO Physician Assistant 508-641-0235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2021-10-15 |