| NPI | 1780120485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY KING Recruitment Coordinator 617-591-4252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MA LN93725) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |