| NPI | 1083727838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYATHRI TALLURI Owner 985-414-0682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-07-07 |