NPI | 1033697859 |
---|---|
Doing Business As | OLD OAK PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | CHRISTOFER JOHN FORT President 203-533-9436 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 056411) |
Enumeration Date | 2018-08-02 |
Last Update Date | 2018-12-21 |