| NPI | 1225628803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH K NEWMAN Owner 386-319-8178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2021-01-19 |