NPI | 1427635358 |
---|---|
Doing Business As | PCC SPORTS MEDICINE AND PRENATAL WELLNESS CLINIC |
Entity Type | Organization |
Authorized Contact | ALYSSA N SIANGHIO President And CEO 708-383-9786 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2021-03-26 |
Last Update Date | 2025-10-08 |