NPI | 1548025596 |
---|---|
Doing Business As | PRIMARY.CLINIC |
Doing Business As | THE MEN'S OPTIMIZATION CLINIC |
Entity Type | Organization |
Authorized Contact | LARRY A MONTGOMERY Owner 478-246-1114 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
Enumeration Date | 2024-02-19 |
Last Update Date | 2024-05-19 |