| NPI | 1043708084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BRUGGEMAN Managing Member 833-210-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 225100000X Physical Therapist | |
| 363AM0700X Physician Assistant, Medical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2020-09-01 |