| NPI | 1629245543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL DARIN SPICHER Billing Clerk 806-771-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM R28624) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-05-09 |