| NPI | 1043400484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH M HARRINGTON Vice President 424-218-9368 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2023-05-26 |