| NPI | 1164158937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVONNA MAGUET Owner 606-215-3488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2024-01-24 |