NPI | 1437661212 |
---|---|
Doing Business As | MARYVALE FAMILY PRACTICE GROUP INC |
Entity Type | Organization |
Authorized Contact | NAHLA CHIRCO Fnp 248-250-3146 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2017-11-01 |
Last Update Date | 2017-11-01 |