NPI | 1699919399 |
---|---|
Entity Type | Organization |
Authorized Contact | ANITA SUSAN PHILIPOSE Nurse Practitioner/Owner 1502-417-4956 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TN 13535) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TN 13535) |
261QU0200X Clinic/Center, Urgent Care (Licence: TN 13535) | |
Enumeration Date | 2009-04-24 |
Last Update Date | 2009-11-12 |