NPI | 1053153114 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC ALLAN SHOEMAKER Md 260-423-2675 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2024-06-10 |
Last Update Date | 2024-06-10 |