| NPI | 1730697483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ABLION Owner 224-234-5025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 104100000X Social Worker | |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2023-04-04 |