| 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 |