| NPI | 1124763685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE GRACE GRIMMETT Family Nurse Practitioner 945-542-0218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-08-02 |