| NPI | 1639403769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON PETERSON Director/Owner 276-638-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2024-07-03 |