| NPI | 1649140856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY A CHAVEZ Vice President 833-381-6736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-11-11 |
| Last Update Date | 2025-12-05 |