| NPI | 1619126653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM FOGARTY Senior VP / Chief Medical Officer 800-232-3550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2008-09-15 |