| NPI | 1881643617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X |
| 207R00000X Internal Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 208600000X Surgery | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2011-06-30 |