| NPI | 1659027043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT SANDERS Owner 270-845-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363LF0000X Nurse Practitioner, Family | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2024-11-14 |