| NPI | 1851602759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAYNA SANDS Manager/Patient Coordinator 888-691-1482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 2647293) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-06-24 |