| NPI | 1528291507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R ANDERSON Officer 877-228-4951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2010-08-30 |