| NPI | 1356800791 |
|---|---|
| Doing Business As | GERONIMO VILLAGE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | JODI GAYLE KOENIG Owner 830-372-8981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2019-06-11 |