NPI | 1275573008 |
---|---|
Entity Type | Organization |
Authorized Contact | GEORGE LEROY GALLENSTEIN Owner 606-759-7878 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363A00000X Physician Assistant |
363L00000X Nurse Practitioner | |
Enumeration Date | 2006-06-08 |
Last Update Date | 2023-11-01 |