| 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 |