| NPI | 1093505406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SMITH Chief Executive Officer 731-618-7179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |