| NPI | 1649918186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK OSBORNE Managing Member 866-665-3244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2023-04-13 |