| NPI | 1265631840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY A KOSSE Office Mgr 940-761-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-11-16 |