NPI | 1154047553 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELE SHAMELL Billing Manager 888-585-5510 |
Organization Subpart ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2022-10-17 |
Last Update Date | 2022-10-17 |