| NPI | 1881368827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH A LININGER President And CEO, Medical Director 984-364-8441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2021-12-21 |