NPI | 1093367963 |
---|---|
Doing Business As | FAMILY HEALTH CLINIC |
Entity Type | Organization |
Authorized Contact | RHONDA TEDETON Credentialing 318-728-8140 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2019-07-11 |
Last Update Date | 2019-07-11 |