| NPI | 1255695334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JASON HARTMAN Physician/Owner 267-437-3299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |