| NPI | 1760604243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PACKER W AMY Billing Manager 888-745-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |