NPI | 1346963261 |
---|---|
Doing Business As | HOMEPLACE OB/GYN |
Entity Type | Organization |
Authorized Contact | ROXANN CORDIAL Credentialing Manager 606-886-8572 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2022-09-26 |
Last Update Date | 2022-09-26 |