NPI | 1710758966 |
---|---|
Doing Business As | MAIN STREET MEDICAL |
Entity Type | Organization |
Authorized Contact | SHARON MARSHALL Owner 817-739-5848 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2024-01-15 |
Last Update Date | 2024-01-15 |