| NPI | 1386415875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN K BUSHMAN President/Owner 580-599-0272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2025-12-18 |