| NPI | 1952858425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY KILPATRICK Credentialing Specialist 781-862-1620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2019-04-11 |