| NPI | 1447699178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ULOMA D ONUBOGU Manager 8508-524-1577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL 2721822) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL 2721822) |
| Enumeration Date | 2013-06-16 |
| Last Update Date | 2016-10-25 |