| NPI | 1396947073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ERIK CLEMENSEN President 866-269-4810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 228650) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-08-06 |