NPI | 1376823922 |
---|---|
Doing Business As | CREEKSIDE FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | SANDRA STEELE Chief Financial Officer 239-658-3003 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2011-08-26 |
Last Update Date | 2011-10-13 |