| NPI | 1144576307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RABENHORST Owner, Doctor 888-953-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 171100000X Acupuncturist |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2012-07-25 |