| NPI | 1346552841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE SPILLANCE Account Manager 800-550-9212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |