| NPI | 1821417072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY BLOMQUIST Managing Member 469-360-3498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2021-06-03 |