NPI | 1679365001 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL SIMMONS CEO 229-888-7420 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2025-05-21 |
Last Update Date | 2025-09-15 |