| NPI | 1891265203 |
|---|---|
| Doing Business As | LAKEWOOD ELEMENTARY HEALTHY KIDS CLINIC |
| Entity Type | Organization |
| Authorized Contact | ERIC E LOY CEO 270-858-6655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2018-11-28 |