| NPI | 1225561012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R HARPER Owner/Physician 855-947-7371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036097080) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |