| NPI | 1740248996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J SULLIVAN Athletic Trainer 617-515-5915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ME AT233) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-22 |