| NPI | 1477708469 |
|---|---|
| Doing Business As | PPGWNI |
| Entity Type | Organization |
| Authorized Contact | KIM A. NELSON VP Of Finance 866-904-7721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2017-04-19 |