| NPI | 1811746811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHALIN E PATTON Owner 469-732-9856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-14 |