| NPI | 1194785972 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DARRYL L. STROMBERG V.P. Operations 866-367-3798  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty | 
| Enumeration Date | 2006-03-24 | 
| Last Update Date | 2020-08-22 |