NPI | 1174003685 |
---|---|
Doing Business As | PREMISE HEALTH - FAYETTEVILLE |
Entity Type | Organization |
Authorized Contact | PETER J VASQUEZ President 844-407-7557 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2018-08-15 |
Last Update Date | 2020-04-29 |