| NPI | 1821971169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM HUNTER Secretary 781-346-4461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-07-25 |