NPI | 1679210181 |
---|---|
Doing Business As | COUNTRY NURSE PRACTITIONER |
Entity Type | Organization |
Authorized Contact | JASON PATRICK ITSON Nurse Practitoner 540-330-4455 |
Organization Subpart ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Enumeration Date | 2022-05-16 |
Last Update Date | 2022-06-21 |