| NPI | 1508810649 |
|---|---|
| Doing Business As | OB-GYN CLINIC |
| Entity Type | Organization |
| Authorized Contact | BRIAN KIRK Vice President 338-289-8951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2011-10-26 |