| NPI | 1417390188 |
|---|---|
| Doing Business As | BLUE DIAMOND PHYSICAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JAMES LUNDIN Staff Provider 972-542-5879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2022-08-22 |