| NPI | 1609438019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN C MAJOR AO 526-348-7363 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2023-04-06 |