| NPI | 1508587627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CARTER Owner 469-480-8772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2023-11-16 |