| NPI | 1588804777 |
|---|---|
| Doing Business As | INDEPENDENCE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KRISTY SVENSON Network Director 866-814-4476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2009-02-27 |