| NPI | 1417485053 |
|---|---|
| Other Name | PROHEALTH SELECT, INC |
| Entity Type | Organization |
| Authorized Contact | NANCY BOURG CEO 800-488-0279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2022-07-21 |