| NPI | 1225772007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINCI ANDERSON Owner 877-926-6463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2024-09-05 |