| NPI | 1487543013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BELINDA GOODWIN Owner/Managing Director 800-229-3514 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-06-30 |