| NPI | 1619832987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY POLMATEER COO 385-201-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2025-12-18 |
| Last Update Date | 2025-12-18 |