| NPI | 1316225147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LAREAUX Medical Director 855-362-9773 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2024-11-26 |