NPI | 1407034127 |
---|---|
Doing Business As | BETWEEN THE LAKES PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | MATTHEW G HEDTKE Executive Director 864-885-7673 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 261QR1300X) |
Enumeration Date | 2008-02-05 |
Last Update Date | 2008-02-05 |