| NPI | 1821185455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN F. KETCHUM President 508-755-9573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: MA 2087) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2008-03-25 |