NPI | 1346095031 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA MOFFITT Administrative Supervisor I 909-777-0726 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
Enumeration Date | 2024-04-17 |
Last Update Date | 2024-04-17 |