NPI | 1821727405 |
---|---|
Entity Type | Organization |
Authorized Contact | ABBIE LYNN INGRAM Owner 617-312-7921 |
Organization Subpart ? | No |
Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical |
Enumeration Date | 2022-06-08 |
Last Update Date | 2022-06-08 |