NPI | 1447971916 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREA CHADWICK Medical Director 800-924-7811 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2022-09-05 |
Last Update Date | 2024-06-24 |