| NPI | 1457460677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEYER LEON PROLER Physician 888-283-5023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X (Licence: TX D0260) |
| Additional Taxonomies | 2084N0600X (Licence: AL SP-5) |
| 2084N0600X (Licence: AK 6371) | |
| 2084N0600X (Licence: AZ 37381) | |
| 2084N0600X (Licence: DC MD035403) | |
| 2084N0600X (Licence: DE C1-0009390) | |
| 2084N0600X (Licence: AR R4671) | |
| 2084N0600X (Licence: CA C53031) | |
| 2084N0600X (Licence: CO 41757) | |
| 2084N0600X (Licence: FL ME88096) | |
| 2084N0600X (Licence: GA 49472) | |
| 2084N0600X (Licence: ID M-9526) | |
| 2084N0600X (Licence: IL 036-101720) | |
| 2084N0600X (Licence: IN 01063043A) | |
| 2084N0600X (Licence: KS 04-30461) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-03-29 |