| NPI | 1922170786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS C. MCKELL Chief Administrative Officer 860-524-4326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2011-03-02 |