| NPI | 1376114546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIC BURGUNDI CORTES Owner/C PT 442-340-4706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2021-07-08 |