Organization
BOSTON SPORTS MEDICINE AND RESEARCH INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM GILL MD (PRESIDENT)
(617) 264-1100
Entity
Organization
Contact information
Practice address
40 ALLIED DR, DEDHAM, MA 02026-6146
(617) 264-1100
(617) 264-1101
Mailing address
40 ALLIED DR, DEDHAM, MA 02026-6146
(617) 264-1100
(617) 264-1101
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
152013
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11060187/A
—
MA
Enumeration date
12/09/2013
Last updated
05/20/2015
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