| NPI | 1710365416 |
|---|---|
| Doing Business As | EVERSIDE HEALTH - PUEBLO FORTINO BLVD |
| Entity Type | Organization |
| Authorized Contact | JILL JOHNSON PATTON Director Of Risk Management 704-936-5546 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2022-08-11 |