| NPI | 1518294008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD T GODBOLD President 800-444-7009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2010-01-08 |