| NPI | 1093006447 |
|---|---|
| Doing Business As | LOURDES 14TH AVENUE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JOHN SERLE CEO 509-543-2483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2011-04-20 |