| NPI | 1316777329 |
|---|---|
| Doing Business As | BAXTER HEALTH COLLEGE STREET FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | DEBRA HENRY CFO 870-508-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |