| NPI | 1730344318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA DENISE DORSEY Certified Pharmacy Technician 972-228-6230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: TX 1701-0654-2361-930) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-07-23 |