| NPI | 1952589434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS C. MCKELL CAO 860-524-4326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2010-08-11 |