| NPI | 1548811870 |
|---|---|
| Doing Business As | WASHINGTON REGIONAL PRIMARY CARE - MAIN STREET |
| Entity Type | Organization |
| Authorized Contact | DANIEL ECKELS CFO 479-463-2825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |