| NPI | 1194186437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY BIGFORD Sole Member 986-224-8420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1252A) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2024-05-11 |