| NPI | 1003427873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COY WILLIAMSON COO 430-200-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 225100000X Physical Therapist | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2023-11-14 |