| NPI | 1447803416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLIAN M LADNER Nurse Practitioner/Owner 228-229-7989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-21 |