| NPI | 1659679363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS P WEBSTER Owner 800-732-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2018-03-21 |