| NPI | 1174107502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY SMITH Owner 973-241-5856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2022-09-19 |