| NPI | 1225114994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN R WADDELL Cma 765-450-5568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01049560A) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2015-01-13 |