| NPI | 1871899518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E STEVENS Owner 888-699-7126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 552592) |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2011-01-27 |