NPI | 1619759636 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTEN DENARO Co Owner 862-352-3005 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
Enumeration Date | 2023-10-16 |
Last Update Date | 2023-10-16 |