| NPI | 1366699878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIJUANA BARBRA Accounts Receivable Manager 270-354-8093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 37587) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |