| NPI | 1235738782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY CALHOUN CEO 877-354-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2020-10-25 |
| Last Update Date | 2020-10-25 |