NPI | 1104351055 |
---|---|
Other Name | DIAMOND BACK ENERGY FAMILY CLINIC |
Entity Type | Organization |
Authorized Contact | TERRY LAYMAN VP Corporate Medical Director 317-522-0844 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2017-04-28 |
Last Update Date | 2024-12-11 |