| NPI | 1255583142 |
|---|---|
| Doing Business As | MEDFAST WALK IN CLINIC |
| Entity Type | Organization |
| Authorized Contact | RAY B WHITMORE Chief Financial Officer 580-208-3104 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2009-01-21 |