| NPI | 1891465175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT KAPPLER COO 888-588-7356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2021-09-17 |