| NPI | 1598112922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER WALLICK Owner 202-277-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R207551) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-08-09 |