| NPI | 1730699679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY MUSIC Director Provider Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2025-02-18 |