| NPI | 1275576522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MLOT President 888-798-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner Family | |
| 363LG0600X Nurse Practitioner Gerontology | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2022-01-18 |