| NPI | 1780081141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE M HOLLENBECK President 909-938-2681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |