| NPI | 1508174434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LEE LARSON Supervisor, Clinical Nurse 315-263-4016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility (Licence: SD R017398) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2010-09-14 |