| NPI | 1114985876 |
|---|---|
| Doing Business As | GOOD SHEPHERD GLENN-GARRETT CLINIC - JEFFERSON |
| Entity Type | Organization |
| Authorized Contact | ED D BANOS President 903-315-1811 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-07-26 |