| NPI | 1841384096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | L. DOUGLAS DOLGOV Sole Proprietor 508-650-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |