| NPI | 1831415801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAINA DULFAN Medical Director 508-154-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 764) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MA 591) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2015-05-15 |