| NPI | 1235959982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY JONES Owner 806-474-4392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 103T00000X Psychologist |
| 231H00000X Audiologist | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-10-16 |