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 |