| NPI | 1225547326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINNE D ANDERSON Account Manager 800-406-4796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P7828) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2019-10-30 |