| NPI | 1598933269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2010-02-24 |