NPI | 1265419261 |
---|---|
Doing Business As | PRIMARY CARE GROUP |
Entity Type | Organization |
Authorized Contact | MICHELLE BOATRIGHT Administrator 618-252-8625 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036042756) |
Enumeration Date | 2005-12-30 |
Last Update Date | 2011-09-22 |