| NPI | 1033773544 |
|---|---|
| Other Name | OC TANNER HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | JERRY FORD CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2021-02-19 |