NPI | 1144891144 |
---|---|
Entity Type | Organization |
Authorized Contact | SARA MARKS CEO 606-408-4401 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
Enumeration Date | 2021-07-09 |
Last Update Date | 2023-06-16 |