| NPI | 1154037190 |
|---|---|
| Doing Business As | OUTLAW FAMILY HEALTH AND WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | KRYSTAL OUTLAW Owner 945-800-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 251E00000X Home Health |
| 305S00000X Point of Service | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-10-22 |