| NPI | 1174976807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH VAUBEL COO 855-466-3631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704250106) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| 261QP1100X Clinic/Center, Podiatric | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2026-05-01 |