| NPI | 1972746550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POLLY LEONARD Owner/Doctor 401-732-2031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2025-02-06 |