| NPI | 1306569546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEE E PERRY Owner 765-251-3987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2025-01-06 |