NPI | 1477204345 |
---|---|
Former Legal Business Name | HYDROFIX- IV & WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | EMMERENCIA MORFAW Nurse Practitioner 124-053-5767 |
Organization Subpart ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
Enumeration Date | 2022-01-12 |
Last Update Date | 2022-01-12 |