| NPI | 1912345646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICITY L MACK Owner 413-862-2563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX p1564) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2024-06-10 |