| NPI | 1780701417 |
|---|---|
| Doing Business As | HEALTHSOURCE: EASTGATE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | JOSEPH W PRATHER II CEO 513-707-4041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2024-09-18 |