| NPI | 1366172512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA MARIE WHORTON Owner 269-779-9435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2022-06-12 |
| Last Update Date | 2023-03-11 |