| NPI | 1679179006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARR BOVA Executive Director, Business 315-824-6560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2023-11-02 |