| NPI | 1225355118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WES DAVIS CEO 800-440-3305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| 208600000X Surgery | |
| 208D00000X General Practice | |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2010-04-30 |