| NPI | 1134097058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MAXILOM POLINTAN Nurse Practitioner/Owner 725-772-1939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-10-24 |
| Last Update Date | 2025-10-24 |