| NPI | 1205432861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD L DEPRANG Owner 325-698-3865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-09 |