| NPI | 1184215329 |
|---|---|
| Former Legal Business Name | INDEPENDENT MEDICAL GROUP, LLC |
| Entity Type | Organization |
| Authorized Contact | STEVE VIXAMAR CEO 800-773-7066 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-01-31 |
| Last Update Date | 2025-05-14 |