| NPI | 1447005764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY BLAIR ELDER Revenue Cycle Administrator 737-247-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-09-12 |