| NPI | 1891512752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON B RICHARDS Manager 203-675-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-09-23 |