| NPI | 1477051795 |
|---|---|
| Doing Business As | HEARTHSIDE MEDICINE FAMILY CARE |
| Entity Type | Organization |
| Authorized Contact | HAVILAH NOEL BRODHEAD Co Owner 970-275-6108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 201407546NP-PP) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-11-13 |