| NPI | 1750952875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS ALGER Owner 712-330-0388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2021-07-09 |