| NPI | 1396610788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FNU MOHAMMED MASOOD Manager 551-344-7630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-12-03 |