NPI | 1104365386 |
---|---|
Entity Type | Organization |
Authorized Contact | DONALD CASEY Owner 270-769-5400 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 207R00000X Internal Medicine |
363L00000X Nurse Practitioner | |
Enumeration Date | 2017-02-21 |
Last Update Date | 2018-04-24 |