| NPI | 1740353937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH C MEDEIROS Manager 508-984-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: MA 351) |
| Additional Taxonomies | 208D00000X General Practice |
| 225700000X Massage Therapist (Licence: MA 305) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2008-07-08 |