| NPI | 1083020895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA RODRIGUEZ President 765-404-4136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL ME100283) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2024-10-02 |