| NPI | 1326405416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORA SORRELL Director 765-749-5290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2024-10-25 |