| NPI | 1699209221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY D SNOOK Medical Doctor/ Owner 385-414-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: UT 5688087-1205) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-20 |