| NPI | 1679761027 |
|---|---|
| Other Name | MARY LOU STROM PRIMARY CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | BAIN PATRIE Credentialing Specialist 860-347-6971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2012-10-30 |