| NPI | 1679062145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE RATCLIFF COO 877-997-3224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101Y00000X Counselor |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2021-10-26 |