| NPI | 1780342394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD C KEECH President /CEO 424-352-0326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2021-12-01 |