| NPI | 1437860889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW B BLANCHARD Owner 225-235-0030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2023-11-20 |