NPI | 1104558006 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY DANHAUER Owner 270-684-2341 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2022-06-29 |
Last Update Date | 2022-09-01 |