| NPI | 1669090510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAUL LEAL Principal 385-355-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |