| NPI | 1710228838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MCSWAIN Medical Director 315-730-7448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 006151) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: NY 201382-1) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2017-10-03 |