NPI | 1013561992 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANNON KNOX President 888-995-0455 |
Organization Subpart ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Additional Taxonomies | 261Q00000X Clinic/Center |
261QP2300X Clinic/Center, Primary Care | |
Enumeration Date | 2019-07-29 |
Last Update Date | 2021-04-22 |