| NPI | 1164938726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIEDA BARROW C RN P/ Provider 267-975-6765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA SP015976) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2019-03-08 |