| NPI | 1366671216 |
|---|---|
| Other Name | TRINITY CLINIC DOUGLAS PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | MARY ANN HARRISON Provider Enrollment Coordinator 9035-101-1113 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2015-04-20 |