| NPI | 1033881180 |
|---|---|
| Former Legal Business Name | INDEPENDENT MEDICAL GROUP, LLC |
| Entity Type | Organization |
| Authorized Contact | STEVE VIXAMAR CEO 800-773-7066 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2025-05-14 |