| NPI | 1679655443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA ANNE BOUCHER Owner 203-238-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: CT 000805) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2010-08-23 |