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 |