NPI | 1215546932 |
---|---|
Entity Type | Organization |
Authorized Contact | LEE ANNE JOSE JONES AO 725-270-8099 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 207R00000X Internal Medicine |
2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2020-07-28 |
Last Update Date | 2024-10-30 |