NPI | 1619409075 |
---|---|
Doing Business As | NEW LEAF PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | CRYSTAL STONE CEO 618-416-7738 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2017-04-03 |
Last Update Date | 2023-07-28 |