| NPI | 1326748070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEATTA BYRD Sole Proprietor 269-290-3248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2023-03-09 |