| NPI | 1952892788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGH VAN DUSEN Owner 781-343-1592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: MA 3284) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |