NPI | 1861038754 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBRA M WOOLDRIDGE Supervisor, Provider Enrollment 508-334-8890 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QA0006X Clinic/Center Ambulatory Fertility Facility |
Enumeration Date | 2019-11-26 |
Last Update Date | 2019-11-26 |