| NPI | 1679518047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ALLEN BELL Director 860-286-9161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 0472) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: CT 0472) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2009-05-22 |