| NPI | 1235459918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTEO REGUIZ CASTRO President 618-942-7371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 36-51919) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |