| NPI | 1881077501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LOGAN Authorized Official 662-841-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2024-10-07 |