| NPI | 1629515325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LANTZ EFFINGER Director/Physician 888-698-2714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS11271) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2021-09-07 |