| NPI | 1023778511 |
|---|---|
| Doing Business As | 4TH STREET CLINIC |
| Entity Type | Organization |
| Authorized Contact | JESSICA ANN WRIGHT Np 812-486-6639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2023-02-24 |