NPI | 1366724825 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM L THORNSON Owner 774-202-7049 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MA 1138975) |
Enumeration Date | 2011-09-12 |
Last Update Date | 2011-09-12 |