| NPI | 1053379057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY L FEUTZ Practice Manager 916-733-6238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: G12170) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-08-22 |