| NPI | 1104473248 |
|---|---|
| Doing Business As | ICARE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JENESA AGUILUZ-DIZON Ap RN 509-713-4619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2020-02-27 |