| NPI | 1578185500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY NAN WHITMEYER Practice Manager 346-246-3424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2021-03-31 |