| NPI | 1740657063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASSIATU BARRIE Owner 469-774-1529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD AC001256) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |