| NPI | 1124272448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA RAYNER Owner 228-388-5144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2008-12-08 |