| 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 Service |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |