NPI | 1063517613 |
---|---|
Doing Business As | FREDERICKTOWN PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | MICHAEL PORTACCI President 615-465-7029 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
Enumeration Date | 2006-09-14 |
Last Update Date | 2022-07-21 |