Organization Name: | HEALTHY CONCEPT FAMILY PRACTICE, LLC |
NPI Number: | 1861752271 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUNJIE FANG (OWNER) |
Mailing Address: | 118 Main St Suite #3 Sturbridge |
State: | MA US |
Postal Code: | 015661533 |
Phone Number: | 7742410450 |
Fax Number: | 7742410583 |
NPI Enumeration Date: | 05/18/2012 |
NPI Last Update Date: | 04/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 238587 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |