| NPI | 1164610036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE KATHRYNE ALEXANDER President/CEO 8002-740-7036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA A81199) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |