| NPI | 1164309175 |
|---|---|
| Doing Business As | ITHACA FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DONALD GRAHAM PROUTY Owner 989-875-4465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-20 |