| NPI | 1891330056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE MORSCHING Chief Financial Officer 888-364-5977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2024-07-15 |