| NPI | 1003356759 |
|---|---|
| Doing Business As | MODOMA |
| Entity Type | Organization |
| Authorized Contact | GRADY MURPHY Owner 469-304-3443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: G3628) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |