NPI | 1124325865 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN MCNULTY Part Owner 270-570-7500 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
Enumeration Date | 2011-02-15 |
Last Update Date | 2020-08-07 |