| NPI | 1801495940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YANCEY GAITHER Owner 623-810-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2022-10-31 |