| NPI | 1578245544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA BUTLER President / CEO 385-333-8936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207Q00000X Family Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-16 |