| NPI | 1073569364 |
|---|---|
| Doing Business As | MED ONE OF ST JOSEPH |
| Entity Type | Organization |
| Authorized Contact | ANDREW KELLAR Regional Practice Administrator 765-457-8381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2007-11-16 |