| NPI | 1467503433 |
|---|---|
| Former Legal Business Name | FAMILY MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | BENNY M PAULINO Chief Operating Officer 671-647-5212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208600000X Surgery | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-11-29 |