| NPI | 1306317060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN KEITH COOK President 340-626-3714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2018-12-06 |