| NPI | 1619492048 |
|---|---|
| Doing Business As | SENIOR DOC IPA |
| Entity Type | Organization |
| Authorized Contact | JOHN M GEISS Chief Executive Officer 855-434-7763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2023-10-25 |