| NPI | 1679115166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN GOMES Credentialing Manager 508-676-3292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2022-12-13 |