| NPI | 1124762281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY BITNER Medical Staff Office 385-430-1430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 133N00000X Nutritionist |
| 163W00000X Registered Nurse | |
| 170100000X Medical Genetics, Ph.D. Medical Genetics | |
| 207K00000X Allergy & Immunology | |
| 207Q00000X Family Medicine | |
| 207RG0100X Internal Medicine Gastroenterology | |
| 207ZC0006X Pathology Clinical Pathology | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2024-05-02 |