| NPI | 1457714420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT FRANCIS HOFFMAN Administrator 270-307-1784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: MD L0005731) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |