| NPI | 1568417459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKRANT SALARIA Director 712-388-2770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2018-03-17 |