| NPI | 1568174118 |
|---|---|
| Other Name | PRIME HEALTH CLINIC LLC |
| Entity Type | Organization |
| Authorized Contact | KELLY POWELL Owner / Provider 747-500-4253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2023-09-22 |