NPI | 1134876329 |
---|---|
Doing Business As | KEEP ACTIVE HEALTH & WELLNESS |
Entity Type | Organization |
Authorized Contact | JOSEPH GOWATY Clinic Director 540-785-8018 |
Organization Subpart ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2022-03-07 |
Last Update Date | 2022-03-07 |