| NPI | 1467997262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA ROETZER Owner 716-228-0439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 206060-1) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2023-03-07 |