NPI | 1689778714 |
---|---|
Former Legal Business Name | LONGNECK FAMILY PRACTICE, PA |
Entity Type | Organization |
Authorized Contact | JEFFREY E HAWTOF Pres 320-947-9767 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2006-09-11 |
Last Update Date | 2011-02-18 |