NPI | 1750592036 |
---|---|
Entity Type | Organization |
Authorized Contact | LYDIA K RAYNER Owner 228-864-0622 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
Enumeration Date | 2007-05-25 |
Last Update Date | 2014-01-03 |