| NPI | 1710259155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER J. LAWLER President 860-633-1928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CT 194) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-22 |