| NPI | 1861001554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GLUCHACKI SVP, Compliance 508-689-9706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2022-04-14 |