| NPI | 1679843379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY L EDINGTON Medical Director 866-322-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA FNP42119) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |