| NPI | 1639685464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE FRETZ Owner 716-570-0524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 200115-1) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2017-12-15 |