| NPI | 1902665839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONOR M BUTTS President 866-747-8341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2026-02-17 |