| NPI | 1528475563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE Q. YOUNG President 769-572-5280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS R861956) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2014-07-22 |