| NPI | 1801340856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN LANCE Doctor/Owner 478-453-2341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA ME53031) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2024-09-19 |