| NPI | 1447932793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER CLARK Owner 915-244-9257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 174400000X Specialist |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2025-08-29 |