| NPI | 1568070142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOIN HANA Md 606-372-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 363A00000X Physician Assistant | |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2021-05-25 |