| NPI | 1548789639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JOSEPH WILSON Owner 940-689-9664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |