| NPI | 1356374854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL VISE SHELTON Owner 432-552-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2024-04-25 |