| NPI | 1891031811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JERNBERG President 800-507-8874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2012-12-19 |