| NPI | 1760049639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOLIE WOODSTOCK Director Of Accounting And Hr 800-450-2152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QG0250X Clinic/Center, Genetics |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-05-24 |