| NPI | 1376791426 |
|---|---|
| Doing Business As | ICON WELLNESS CENTER LLC |
| Entity Type | Organization |
| Authorized Contact | JOHN ROBERT JOHNSTON Medical Director 281-724-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |