| NPI | 1780261701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID FAIRCHILD President And Chief Medical Office 877-868-5351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2023-10-26 |