| NPI | 1245781574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE LOUISE KREUZER Registered Pharmacist 1208-736-5373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: ID P5593) |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2016-10-21 |