NPI | 1467510966 |
---|---|
Doing Business As | BRISTOL STREET FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | RICHARD ALLEN HASTINGS Owner 574-262-2817 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01027071A) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2008-06-12 |