NPI | 1114759297 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSEPH SEELOW Credentialing Coordinator 815-650-0886 |
Organization Subpart ? | No |
Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
Enumeration Date | 2024-08-16 |
Last Update Date | 2024-09-17 |