| NPI | 1851454946 |
|---|---|
| Doing Business As | NORTHSIDE CLINIC |
| Entity Type | Organization |
| Authorized Contact | DEBBIE KRUSE Office Manager 251-675-4733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2008-05-05 |