| NPI | 1831344183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA STANTON-DEENER Nurse Practitioner 844-373-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2008-11-27 |
| Last Update Date | 2023-03-20 |