NPI | 1801266499 |
---|---|
Doing Business As | LT PROACTIVE CARE CLINIC |
Entity Type | Organization |
Authorized Contact | KAMBIZ FARBAKHSH Owner/Medical Director 952-541-7157 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
Enumeration Date | 2015-09-25 |
Last Update Date | 2015-09-25 |