| NPI | 1144770041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI I LEE Senior Director Revenue Cycle 844-969-0686 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2023-12-28 |