| NPI | 1053734780 |
|---|---|
| Doing Business As | AFFINITY HEALTH GROUP ULM CLINIC |
| Entity Type | Organization |
| Authorized Contact | MIKE BREARD Vice President 318-361-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-01-31 |