| NPI | 1831970557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI PIERSANTI Managing Director 877-969-6863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2024-05-21 |