NPI | 1467056234 |
---|---|
Doing Business As | BAXTER HEALTH MAIN STREET FAMILY CLINIC |
Entity Type | Organization |
Authorized Contact | DEBRA HENRY CFO 870-508-1003 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2020-11-23 |
Last Update Date | 2023-05-04 |