NPI | 1053065201 |
---|---|
Other Name | SMITH FAMILY WELLNESS CLINIC |
Entity Type | Organization |
Authorized Contact | STEFANI PRISCILIA RUARTE Credentialing Coordinator 704-316-6573 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2022-02-07 |
Last Update Date | 2022-08-15 |