| NPI | 1790655538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY GWIRTZ Director 833-944-7855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101Y00000X Counselor |
| 163W00000X Registered Nurse | |
| 208U00000X Clinical Pharmacology | |
| 225100000X Physical Therapist | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2025-11-06 |
| Last Update Date | 2025-11-06 |