NPI | 1649553892 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERISE ELMORE Medical Billing Manger 708-798-8112 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
Enumeration Date | 2011-09-23 |
Last Update Date | 2012-09-18 |