| NPI | 1740977073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN VARTANIAN Manager 603-630-9023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |