| NPI | 1710137195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2010-07-16 |