| NPI | 1831251693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN E WASCAVAGE Owner 508-879-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-04-05 |