| NPI | 1871207555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANYSTIN BIGLER Manager, Payer Credentialing 339-463-6787 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2083B0002X Preventive Medicine, Obesity Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2026-05-28 |