| NPI | 1750635967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ALEXANDER LYONS Member 860-573-4923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CT LLC 1084683) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2013-04-22 |